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Lafene Health Center

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. DON’T 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:
    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.

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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! Don’t 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 can’t be deciphered may delay your results.
  • If you have questions, call the dietitian at 785.532.6544.

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Let’s 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.

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. Don’t forget to include the milk you add to your cereal. Designate if an item is ‘reduced fat,’ ‘low fat’ or ‘sugar-free.’


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: B—breakfast, L—lunch, D—dinner, S—snack.


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.


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


How were you feeling while you were eating? (sad, happy, bored, depressed)

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Sample Food Record

Food or DrinkSpecifics
How Much What Kind Time Where Alone or with whom Activity Mood
3chocolate chip cookies3:25 pmSThe “Derb”friends happy
1cheeseburger6:15 pmDBurger KingClaire, Jackietalkinghappy
1regular French fries  Burger King   
1vanilla shake  Burger King   
1 cupHaagen Dazs ice cream10:00 pmSdorm roomalonewatching TVbored
1 cupCaptain Crunch1:00 amSdorm roomalonestudyingtired
½ cup2% milk1:00 amSdorm roomalonestudyingtired

Food Record Forms (These forms are in PDF format, which requires Adobe Acrobat to view and print.)

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Nutrition Counseling
Room 257
by appointment

Dianna Schalles,
M.S, R.D., L.D.