Daily Food Log Template1 Rev 9-2011HN (2)

Page 1

Daily Food Diary Name:

Protein Guidelines: Minimum protein requirement 1st 30 days after surgery.

Date:

Men 70 and Women 60 grams per day.

After the 1st month you will need to take in the individually calculated protein needs provided to you by your Dietitian.

Meal

Food Eaten

Amount Protein

Comments

Grams Mini Meal #1 Time: ______ Mini Meal #2 Time: ______ Mini Meal #3 Time: ______ Mini Meal #4 Time: ______ Mini Meal #5 Time: ______ Protein Grams consumed

TOTAL:

Water (8 ounces) Multi-Vitamin Taken:

Yes

Time: (1)

Time: (2)

Remember to eat every 3-4 hours a mini meal.

B-12 Taken:

Yes Date:

Iron Taken:

Yes Time:

Exercise type/duration Calcium Taken: Time: (1)

Time: (2)

Time: (3)

Yes PPI Taken:

Yes

Time:

Urso Taken:

Yes Time:


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