Food Journal for Health: Personalized Plan for Losing Fat and Building Muscles
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This food journal provides a personalized plan for losing fat and building muscles. It includes a sample menu for three meals and three snacks, grouped into five food groups. The plan involves 1 1/2 - 2 bowls of fruits and 2 1/2 - 3 1/2 bowls of vegetables, 5-8 ounces of grains, 1/2 from whole grain, three bowls of non-fat or low-fat dairy food, and 5-6 1/2 ounces of protein such as meats, bean, and seafood per day.
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[Document subtitle]
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Patient name: ______________________________________ Date of Birth: ________________
OCTOBER 18, 2018
student details:
[Document subtitle]
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Patient name: ______________________________________ Date of Birth: ________________
OCTOBER 18, 2018
student details:
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Part I:
Food Journal Day 1
Date: 11/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30am/pm
Food/Beverage items Amount/Serving size
Banana and strawberry smoothie
Oatmeal with quick cooking oats and one tablespoon of raisins
Scramble eggsin microwave and roll them with wheat tortilla and
black peppers
I small glass
1 bowl
2 eggs
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Tomato and black bean with lentils, squash, carrot, cauliflower or
broccoli soup
Mixed salad greens and toss with fresh or grilled chopped
vegetables, goat cheese, and balsamic vinegar dressing.
Stir fry with rice
1 cup
2 cup/ 1 tablespoon
1 bowl
Dinner Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Burger With Mushrooms and Radicchio
Brown Rice Bowl
Green salads
1 slice
1 bowl
1 bowl
Snacks
Time of day Food/Beverage items Amount/Serving size
10.30 am/pm
04.00 am/pm
10.00 am/pm
Fresh apple
Green tea
Brown bread
1 small
1 cup (8 Oz)
2 slices
Estimated Daily Water Intake: 68ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
1
Patient name: ______________________________________ Date of Birth: ________________
Food Journal Day 1
Date: 11/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30am/pm
Food/Beverage items Amount/Serving size
Banana and strawberry smoothie
Oatmeal with quick cooking oats and one tablespoon of raisins
Scramble eggsin microwave and roll them with wheat tortilla and
black peppers
I small glass
1 bowl
2 eggs
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Tomato and black bean with lentils, squash, carrot, cauliflower or
broccoli soup
Mixed salad greens and toss with fresh or grilled chopped
vegetables, goat cheese, and balsamic vinegar dressing.
Stir fry with rice
1 cup
2 cup/ 1 tablespoon
1 bowl
Dinner Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Burger With Mushrooms and Radicchio
Brown Rice Bowl
Green salads
1 slice
1 bowl
1 bowl
Snacks
Time of day Food/Beverage items Amount/Serving size
10.30 am/pm
04.00 am/pm
10.00 am/pm
Fresh apple
Green tea
Brown bread
1 small
1 cup (8 Oz)
2 slices
Estimated Daily Water Intake: 68ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
1
Patient name: ______________________________________ Date of Birth: ________________
Food Journal Day 2
Date: 06/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day:08.00am/pm
Food/Beverage items Amount/Serving size
Baked beans on the toast with green peppers
Mix canned peaches with low fat yogurt
Juice made with Tomato and coriander leaves
Cantaloupe slices with dumpling
2 slice
1 cup
1 small glass
1 slice
Lunch Time of day:12.30am/pm
Food/Beverage items Amount/Serving size
Diet coke
Presto cheese pasta
French fries
16 Oz
1 plate
1 bag
Dinner Time of day:07.00am/pm
Food/Beverage items Amount/Serving size
Baked potato with salsa
Sweet Potato and Spinach Quesadillas
Glass of milk
2 pieces
1 bowl
I small glass
Snacks
Time of day Food/Beverage items Amount/Serving size
10.00 am/pm
3.00am/pm
9.00 am/pm
Orange
black coffee
chocolate ice-cream
One piece
1 cup (3 Oz)
Half cup
Estimated Daily Water Intake: 55ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________________
2
Patient name: ______________________________________ Date of Birth: ________________
Date: 06/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day:08.00am/pm
Food/Beverage items Amount/Serving size
Baked beans on the toast with green peppers
Mix canned peaches with low fat yogurt
Juice made with Tomato and coriander leaves
Cantaloupe slices with dumpling
2 slice
1 cup
1 small glass
1 slice
Lunch Time of day:12.30am/pm
Food/Beverage items Amount/Serving size
Diet coke
Presto cheese pasta
French fries
16 Oz
1 plate
1 bag
Dinner Time of day:07.00am/pm
Food/Beverage items Amount/Serving size
Baked potato with salsa
Sweet Potato and Spinach Quesadillas
Glass of milk
2 pieces
1 bowl
I small glass
Snacks
Time of day Food/Beverage items Amount/Serving size
10.00 am/pm
3.00am/pm
9.00 am/pm
Orange
black coffee
chocolate ice-cream
One piece
1 cup (3 Oz)
Half cup
Estimated Daily Water Intake: 55ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________________
2
Patient name: ______________________________________ Date of Birth: ________________
Food Journal Day 3
Date: 7/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Breakfast biscuit with egg, cheese
Fried eggs and bacon
Salty sandwiches with double cheese slices
Ramen cheesy noodle
4 pieces
2 eggs
1 slice
1 plate
Lunch Time of day: 02.00am/pm
Food/Beverage items Amount/Serving size
A glass of fortified soy beverage
a container of yogurt
Steamed fish with broccoli and green beans
1 cup
6 Oz
1 slice
Dinner Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Grapefruit and Avocado Salad
Hotdog with baked beans
Veggies salad
1 bowl
1 medium
1 bowl
Snacks
Time of day Food/Beverage items Amount/Serving size
am/pm
04.00am/pm
10.00 am/pm
-
banana shake
chocolate pastry
1 glass
1 slice
Estimated Daily Water Intake: 45ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
3
Patient name: ______________________________________ Date of Birth: ________________
Date: 7/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Breakfast biscuit with egg, cheese
Fried eggs and bacon
Salty sandwiches with double cheese slices
Ramen cheesy noodle
4 pieces
2 eggs
1 slice
1 plate
Lunch Time of day: 02.00am/pm
Food/Beverage items Amount/Serving size
A glass of fortified soy beverage
a container of yogurt
Steamed fish with broccoli and green beans
1 cup
6 Oz
1 slice
Dinner Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Grapefruit and Avocado Salad
Hotdog with baked beans
Veggies salad
1 bowl
1 medium
1 bowl
Snacks
Time of day Food/Beverage items Amount/Serving size
am/pm
04.00am/pm
10.00 am/pm
-
banana shake
chocolate pastry
1 glass
1 slice
Estimated Daily Water Intake: 45ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
3
Patient name: ______________________________________ Date of Birth: ________________
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Food Journal Day 4
Date: 08/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
Chocolate strawberry smoothie
Cheesy pasta
Omelette
1 glass
1 plate
2 piece
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Broccoli soup with sour cream
Mixed fruit and veggies salad
pizza
1 cup / 1 tablespoon
2 bowls
1 large
Dinner Time of day: 08.30am/pm
Food/Beverage items Amount/Serving size
Chicken soup with cream
Shrimp Ceviche
Soya milk
1 bowl/1 tablespoon
1 bowl
1 large glass
Snacks
Time of day Food/Beverage items Amount/Serving size
09.00 am/pm
05.00 am/pm
08.45 am/pm
Green grapes
Lemon juice
Pastries
1 bowl
1 glass
1 chocolate/1 vanilla
Estimated Daily Water Intake: 65ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
4
Patient name: ______________________________________ Date of Birth: ________________
Date: 08/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
Chocolate strawberry smoothie
Cheesy pasta
Omelette
1 glass
1 plate
2 piece
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Broccoli soup with sour cream
Mixed fruit and veggies salad
pizza
1 cup / 1 tablespoon
2 bowls
1 large
Dinner Time of day: 08.30am/pm
Food/Beverage items Amount/Serving size
Chicken soup with cream
Shrimp Ceviche
Soya milk
1 bowl/1 tablespoon
1 bowl
1 large glass
Snacks
Time of day Food/Beverage items Amount/Serving size
09.00 am/pm
05.00 am/pm
08.45 am/pm
Green grapes
Lemon juice
Pastries
1 bowl
1 glass
1 chocolate/1 vanilla
Estimated Daily Water Intake: 65ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
4
Patient name: ______________________________________ Date of Birth: ________________
Food Journal Day 5
Date: 09/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Apple shake
Cheese toasts
Veggie sandwich
1 glass
2 slices
2 pieces
Lunch Time of day: 12.30am/pm
Food/Beverage items Amount/Serving size
Stir fry with rice
Diet coke
Red velvet muffins
1 plate
16 Oz
3 pieces
Dinner Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Chicken with Cheesy Broccoli Soup
Zesty Tofu and Quinoa
Lemon and honey juice
I cup/ 2 cheese pieces
1 plate
1 cup
Snacks
Time of day Food/Beverage items Amount/Serving size
10.00 am/pm
02.00am/pm
09.00 am/pm
Water melon juice
Bananas
Cheesy puff
1 small glass
2 pieces
2 slices
Estimated Daily Water Intake: 60ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
5
Patient name: ______________________________________ Date of Birth: ________________
Date: 09/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Apple shake
Cheese toasts
Veggie sandwich
1 glass
2 slices
2 pieces
Lunch Time of day: 12.30am/pm
Food/Beverage items Amount/Serving size
Stir fry with rice
Diet coke
Red velvet muffins
1 plate
16 Oz
3 pieces
Dinner Time of day: 07.00am/pm
Food/Beverage items Amount/Serving size
Chicken with Cheesy Broccoli Soup
Zesty Tofu and Quinoa
Lemon and honey juice
I cup/ 2 cheese pieces
1 plate
1 cup
Snacks
Time of day Food/Beverage items Amount/Serving size
10.00 am/pm
02.00am/pm
09.00 am/pm
Water melon juice
Bananas
Cheesy puff
1 small glass
2 pieces
2 slices
Estimated Daily Water Intake: 60ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
5
Patient name: ______________________________________ Date of Birth: ________________
Food Journal Day 6
Date: 10/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
strawberry shake
noodles
crispy corns
1 glass
1 plate
1 plate
Lunch Time of day: 02.30am/pm
Food/Beverage items Amount/Serving size
Cheesy Marconi
butter milk
burgers
1 plate
2 glasses
2 burgers
Dinner Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Pork with Roasted Vegetables
Seared Scallops with Lemon Juice and Sage
Glass of milk
1 plate
1 plate
1 glass
Snacks
Time of day Food/Beverage items Amount/Serving size
am/pm
am/pm
am/pm
-
-
-
Estimated Daily Water Intake: 64ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
6
Patient name: ______________________________________ Date of Birth: ________________
Date: 10/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
strawberry shake
noodles
crispy corns
1 glass
1 plate
1 plate
Lunch Time of day: 02.30am/pm
Food/Beverage items Amount/Serving size
Cheesy Marconi
butter milk
burgers
1 plate
2 glasses
2 burgers
Dinner Time of day: 08.00am/pm
Food/Beverage items Amount/Serving size
Pork with Roasted Vegetables
Seared Scallops with Lemon Juice and Sage
Glass of milk
1 plate
1 plate
1 glass
Snacks
Time of day Food/Beverage items Amount/Serving size
am/pm
am/pm
am/pm
-
-
-
Estimated Daily Water Intake: 64ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
6
Patient name: ______________________________________ Date of Birth: ________________
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Food Journal Day 7
Date: 11/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
Cold coffee with ice-cream
Masala oats
Toasts with beans
1 cup
1 plate
2 toasts
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Honey chilly potato
Fried rice
Blue lagoon
1 plate
1 bowl
2 glasses
Dinner Time of day: 08.30am/pm
Food/Beverage items Amount/Serving size
Cheesy Veggie Pasta
Hot and sour soup with sour cream
Shrimp and Broccoli Pasta Salad with cheese slice
1 bowl
1 cup/ 1 tablespoon
1 bowl/ 2 slices
Snacks
Time of day Food/Beverage items Amount/Serving size
11.00 am/pm
am/pm
11.00 am/pm
green apples
-
Butter scotch ice cream
2 apples
1 cup
Estimated Daily Water Intake: 68ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
7
Patient name: ______________________________________ Date of Birth: ________________
Date: 11/10/2018 CIRCLE ONE: Weekday Weekend
Breakfast Time of day: 8.30 am/pm
Food/Beverage items Amount/Serving size
Cold coffee with ice-cream
Masala oats
Toasts with beans
1 cup
1 plate
2 toasts
Lunch Time of day: 01.00am/pm
Food/Beverage items Amount/Serving size
Honey chilly potato
Fried rice
Blue lagoon
1 plate
1 bowl
2 glasses
Dinner Time of day: 08.30am/pm
Food/Beverage items Amount/Serving size
Cheesy Veggie Pasta
Hot and sour soup with sour cream
Shrimp and Broccoli Pasta Salad with cheese slice
1 bowl
1 cup/ 1 tablespoon
1 bowl/ 2 slices
Snacks
Time of day Food/Beverage items Amount/Serving size
11.00 am/pm
am/pm
11.00 am/pm
green apples
-
Butter scotch ice cream
2 apples
1 cup
Estimated Daily Water Intake: 68ounces/cups
Was this a typical day’s intake? □ yes □ no
Comments: __________________________________________________________________________
7
Patient name: ______________________________________ Date of Birth: ________________
Part II: Personalized plan
My fitness goal is to lose fat and build muscles. I want to improve my athletic skills and joint
flexibility. According to food journal, my current diet is not so consistent because I do three or four
cheat meals per week to stay sane.
Foods are grouped together because they provide similar amounts of key nutrients (Miraj, & Kiani,
2016).The five food groups are following:
vegetable and legumes or beans
fruits
lean meats, poultry, fish, egg, nuts and seeds, tofu legumes/beans
grain food or wholegrain and high cereal fibre assortments
milk, yoghurt, cheese and alternatives, mostly reduced fat (Dabawala, et. al, 2017)
1 1/2 - 2 bowls of fruits and 2 1/2 - 3 1/2 bowls of vegetables. 5-8 ounces of grains, 1/2 from whole
grain. Three bowls of non-fat or low-fat dairy food. 5-6 1/2 ounces of protein such as meats, bean, and
seafood per day. I will include these in my diet (Kundi, et. al, 2016).
Every plan involves three meals and three snacks to make feeling satisfied for long time (Madhuri, et. al,
2014). Sample menu is as follows-
Day one-
Breakfast
fruits like grapes
2 pieces whole grain toast One cup low-fat milk
1 cup black coffee or tea
8
Patient name: ______________________________________ Date of Birth: ________________
My fitness goal is to lose fat and build muscles. I want to improve my athletic skills and joint
flexibility. According to food journal, my current diet is not so consistent because I do three or four
cheat meals per week to stay sane.
Foods are grouped together because they provide similar amounts of key nutrients (Miraj, & Kiani,
2016).The five food groups are following:
vegetable and legumes or beans
fruits
lean meats, poultry, fish, egg, nuts and seeds, tofu legumes/beans
grain food or wholegrain and high cereal fibre assortments
milk, yoghurt, cheese and alternatives, mostly reduced fat (Dabawala, et. al, 2017)
1 1/2 - 2 bowls of fruits and 2 1/2 - 3 1/2 bowls of vegetables. 5-8 ounces of grains, 1/2 from whole
grain. Three bowls of non-fat or low-fat dairy food. 5-6 1/2 ounces of protein such as meats, bean, and
seafood per day. I will include these in my diet (Kundi, et. al, 2016).
Every plan involves three meals and three snacks to make feeling satisfied for long time (Madhuri, et. al,
2014). Sample menu is as follows-
Day one-
Breakfast
fruits like grapes
2 pieces whole grain toast One cup low-fat milk
1 cup black coffee or tea
8
Patient name: ______________________________________ Date of Birth: ________________
(Macronutrients: about 555 calories with 27 grams protein, 63 grams carbohydrates, and 23 grams fat)
Snack
1 banana
1 cup plain yogurt including honey
1 Glass of water
(Macronutrients: 360 calories, 14 grams protein, 78 grams carbohydrates)
Lunch
Baked chicken breast
Salad dressing
Glass of water
(Macronutrients: 425 calories, 44 grams protein, 37 grams carbohydrates, 9 grams fat)
Snack
1 cup carrots
Half piece of pita bread
1 glass of water (Parisotto, et. al, 2015)
(Macronutrients: 157 calories, 6 grams protein, 25 grams carbohydrates, 5 grams fat)
Dinner
1 bowl broccoli
1 bowl brown rice
Small garden salad with one cup spinach leaves, tomato, and onion
9
Patient name: ______________________________________ Date of Birth: ________________
Snack
1 banana
1 cup plain yogurt including honey
1 Glass of water
(Macronutrients: 360 calories, 14 grams protein, 78 grams carbohydrates)
Lunch
Baked chicken breast
Salad dressing
Glass of water
(Macronutrients: 425 calories, 44 grams protein, 37 grams carbohydrates, 9 grams fat)
Snack
1 cup carrots
Half piece of pita bread
1 glass of water (Parisotto, et. al, 2015)
(Macronutrients: 157 calories, 6 grams protein, 25 grams carbohydrates, 5 grams fat)
Dinner
1 bowl broccoli
1 bowl brown rice
Small garden salad with one cup spinach leaves, tomato, and onion
9
Patient name: ______________________________________ Date of Birth: ________________
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Lemon water
(646 calories, 42 grams protein, 77 grams carbohydrates, 8 grams fat)
Snack
1 cup blueberries
2 tablespoons whipped cream
Glass of water
(About 100 calories, 1 gram protein, 22 grams carbohydrates, 2 grams fat)
Day Two-
Breakfast
1 whole wheat muffins with two tablespoons peanut butter
1 fruit
1 butter milk
1 cup black tea
(Macronutrients: approximately 521 calories with 27 grams protein, 69 grams carbohydrates, and 18
grams fat)
Lunch
1 turkey sandwich
1 cup low-sodium vegetable soup
Some water
(Macronutrients: 437 calories, 59 grams protein, 37 grams carbohydrates, 6 grams fat)
10
Patient name: ______________________________________ Date of Birth: ________________
(646 calories, 42 grams protein, 77 grams carbohydrates, 8 grams fat)
Snack
1 cup blueberries
2 tablespoons whipped cream
Glass of water
(About 100 calories, 1 gram protein, 22 grams carbohydrates, 2 grams fat)
Day Two-
Breakfast
1 whole wheat muffins with two tablespoons peanut butter
1 fruit
1 butter milk
1 cup black tea
(Macronutrients: approximately 521 calories with 27 grams protein, 69 grams carbohydrates, and 18
grams fat)
Lunch
1 turkey sandwich
1 cup low-sodium vegetable soup
Some water
(Macronutrients: 437 calories, 59 grams protein, 37 grams carbohydrates, 6 grams fat)
10
Patient name: ______________________________________ Date of Birth: ________________
Dinner
One bowl potatoes
1 bowl spinach
1 bowl beans
1 lemon water
(671 calories, 44 grams protein, 63 grams carbohydrates, 18 grams fat)
Snack
2 pieces brown bread
1 cup non-fat milk
1 Glass of water
(Approximately 337 calories, 14 grams protein, 66 grams carbohydrates, 3 grams fat)
Day Three-
Breakfast
1 medium bran muffin
1 orange
1 cup butter milk
1 cup black coffee
(Macronutrients: approximately 543 calories with 26 grams protein, 84 grams carbohydrates, and 15
grams fat)
Snack
11
Patient name: ______________________________________ Date of Birth: ________________
One bowl potatoes
1 bowl spinach
1 bowl beans
1 lemon water
(671 calories, 44 grams protein, 63 grams carbohydrates, 18 grams fat)
Snack
2 pieces brown bread
1 cup non-fat milk
1 Glass of water
(Approximately 337 calories, 14 grams protein, 66 grams carbohydrates, 3 grams fat)
Day Three-
Breakfast
1 medium bran muffin
1 orange
1 cup butter milk
1 cup black coffee
(Macronutrients: approximately 543 calories with 26 grams protein, 84 grams carbohydrates, and 15
grams fat)
Snack
11
Patient name: ______________________________________ Date of Birth: ________________
1 fresh pear
1 cup flavored soy milk
Hot tea
(Macronutrients: 171 calories, 6 grams protein, 34 grams carbohydrates, 2 grams fat)
Lunch
Low sodium chicken noodle soup
1 green apple
Water
(Macronutrients: 329 calories, 8 grams protein, 38 grams carbohydrates, 17 grams fat)
Dinner
1 bowl baked beans
1 bowl cooked carrots
1 cup cooked kale
(784 calories, 84 grams protein, 76 grams carbohydrates, 3 grams fat)
Snack
1 cup of frozen yogurt
1 cup fresh raspberries (Gopinath, Rahman &Awad, 2015).
(Approximately 285 calories, 7 grams protein, 52 grams carbohydrates, 7 grams fat)
12
Patient name: ______________________________________ Date of Birth: ________________
1 cup flavored soy milk
Hot tea
(Macronutrients: 171 calories, 6 grams protein, 34 grams carbohydrates, 2 grams fat)
Lunch
Low sodium chicken noodle soup
1 green apple
Water
(Macronutrients: 329 calories, 8 grams protein, 38 grams carbohydrates, 17 grams fat)
Dinner
1 bowl baked beans
1 bowl cooked carrots
1 cup cooked kale
(784 calories, 84 grams protein, 76 grams carbohydrates, 3 grams fat)
Snack
1 cup of frozen yogurt
1 cup fresh raspberries (Gopinath, Rahman &Awad, 2015).
(Approximately 285 calories, 7 grams protein, 52 grams carbohydrates, 7 grams fat)
12
Patient name: ______________________________________ Date of Birth: ________________
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13
Patient name: ______________________________________ Date of Birth: ________________
Patient name: ______________________________________ Date of Birth: ________________
References
Dabawala, S., Suprabha, B. S., Shenoy, R., Rao, A., & Shah, N. (2017). Parenting style and oral health
practices in early childhood caries: a case–control study. International journal of paediatric
dentistry, 27(2), 135-144.
Gopinath, V. K., Rahman, B., & Awad, M. A. (2015). Assessment of gingival health among school
children in Sharjah, United Arab Emirates. European journal of dentistry, 9(1), 36.
Kundi, F. M., Habib, A., Habib, A., & Asghar, M. Z. (2016). Android-Based Health Care Management
System. International Journal of Computer Science and Information Security, 14(7), 77.
Madhuri, S., Hegde, S. S., Ravi, S., Deepti, A., & Simpy, M. (2014). Comparison of chewing ability, oral
health related quality of life and nutritional status before and after insertion of complete
denture amongst edentulous patients in a Dental College of Pune. Ethiopian journal of health
sciences, 24(3), 253-260
Miraj, S., & Kiani, S. (2016). Menstrual diseases as stated in canon fil-Tibb. Der Pharmacia Lettre, 8(6),
261-268.
Parisotto, T. M., Stipp, R., Rodrigues, L. K. A., Mattos-Graner, R. O., Costa, L. S., & Nobre-Dos-Santos, M.
(2015). Can insoluble polysaccharide concentration in dental plaque, sugar exposure and
cariogenic microorganisms predict early childhood caries? A follow-up study. Archives of oral
biology, 60(8), 1091-1097.
14
Patient name: ______________________________________ Date of Birth: ________________
Dabawala, S., Suprabha, B. S., Shenoy, R., Rao, A., & Shah, N. (2017). Parenting style and oral health
practices in early childhood caries: a case–control study. International journal of paediatric
dentistry, 27(2), 135-144.
Gopinath, V. K., Rahman, B., & Awad, M. A. (2015). Assessment of gingival health among school
children in Sharjah, United Arab Emirates. European journal of dentistry, 9(1), 36.
Kundi, F. M., Habib, A., Habib, A., & Asghar, M. Z. (2016). Android-Based Health Care Management
System. International Journal of Computer Science and Information Security, 14(7), 77.
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