FUEL4U Adult Questionnaire
Client confidentiality will be maintained at all times. Please allow 30-45 minutes to complete this questionnaire.
DIET & NUTRITION JOURNAL
The goal of a diet & nutrition journal is to get a snapshot of your current dietary patterns and habits. This
type of self-reflection can be very useful in our work together, but it is important that your journaling is
reflective of your typical eating pattern. Please be as honest and accurate as you can, as the information you
provide will better reflect on your eating habits.
HERE ARE THE GUIDELINES:
- You will be recording everything you EAT and DRINK for 3 days. You should choose days that will be TYPICAL for your current eating & lifestyle pattern – ideally 2 weekdays and 1 weekend day.
- You will use the journals provided to write down all meals, snacks, beverages, and supplements you consume. You will note the time of day you are eating or drinking as well as the quantity and as much detail as possible.
- When you record supplements (i.e. vitamins, minerals, protein powders, sport supplements, shakes, etc.), please include the name of the supplement and the amount you take.
- When you record beverages, note the volume of the beverage as well as the type/source/brand/flavor, etc. Remember 1 cup = 250mL = 8 fluid oz
- When you record foods, note the estimated serving size using the images below.
PROTEIN
1 serving = 3 oz
~ the size of the palm of your hand
CARBS
FRUIT, GRAINS & COOKED/STARCHY VEGGIES
1 serving = ½ cup ~ the size of your cupped palmFATS
1 serving = 1 tablespoon
~ the size of your thumb
RAW VEGGIES
1 serving = 1 cup
~ the size of your fist
- Also note the brand of food if purchased including all condiments, sauces, etc. that accompanied the meal. If you prepared the meal, include everything added during cooking (cooking oil, butter, etc.).
- Include details like color (green or red pepper, white or Rye bread); cooking style (grilled, fried,
steamed); source (fresh, frozen, dried, canned); fat content (skim, 2%, full-fat, lean-ground beef). - Don’t forget to include snacks!
When in doubt … include more details!
DIET & NUTRITION JOURNAL
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