Daily Food and Physical Activity Diary · Standard Handouts • S08 Version 5.0 Page 1 of 6 S08...

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www.move.va.gov Page 1 of 6 Standard Handouts S08 Version 5.0 S08 Daily Food and Physical Activity Diary Instructions for Completing the Daily Food and Physical Activity Diary MOVE!® is all about helping you manage your weight. This diary is designed to help you monitor your weight, physical activity, and dietary intake. This will be one of your most valuable tools to reach your goals because it will increase your awareness and help you change. Complete the diary as frequently as possible. It is worth the effort! Food and Beverages 1. In the top section of the diary: Write your name and the date. Fill in your daily calorie goal. Use this chart to select your calories. Set a weekly food goal to improve your diet. Example: “I will cut down on calories by eliminating snacking while watching TV in the evenings this week,” or “I will drink water or sugar-free beverages in place of regular soda this week.” 2. Weigh yourself daily and record your weight in the header row,next to the day. 3. Write down everything you eat and drink, and the amount. If you know the measured amount, list it. If you don’t know the exact amount then estimate the size (2" x 1" x 1"), the volume (½ cup), the weight (2 ounces), and/or the number of items (12) of that type of food. Include as much detail as possible. 4. Complete the line that has “M PC H” listed: Circle M if you were mindful (aware of what & how much you ate). Circle PC if the meal was portion-controlled (see Handout S06, Making Healthy Food Choices with a Healthy Plate). Circle H if the meal was healthy (see Handout S06). Mark the numbers on 1–10 Hunger/Fullness rating scale (1=starving, 5=neither hungry nor full, 10=uncomfortably full) · Place an X over the number that represents the Pre-meal hunger/fullness level. · Draw a circle around the number that represents the Post-meal hunger/fullness level. 5. Fill in a word to describe your mood (happy, content, sad, angry, lonely, excited, exhausted, bored, anxious, fearful, or any other emotion). 6. Use a calorie counter to enter total calories for the day. Purchase a booklet, use a Web site or a Smartphone App to count calories easily. 7. At the end of the day, circle whether you met your goal for the day: If you met your goal, circle “I did it!” If you almost met your goal, circle “Almost.” If you didn’t achieve your goal, circle “Try again.” Current Weight Daily Calorie Goal Under 200 pounds 1200–1500 calories per day 200–225 pounds 1500–1800 calories per day 226–250 pounds 1800–2000 calories per day 251–300 pounds 2000–2500 calories per day 301–350 pounds 2500–3000 calories per day Over 350 pounds See a MOVE!® Dietitian

Transcript of Daily Food and Physical Activity Diary · Standard Handouts • S08 Version 5.0 Page 1 of 6 S08...

www.move.va.gov Page 1 of 6Standard Handouts • S08 Version 5.0

S08

Daily Food and Physical Activity DiaryInstructions for Completing the Daily Food and Physical Activity DiaryMOVE!® is all about helping you manage your weight. This diary is designed to help you monitor your weight, physical activity, and dietary intake. This will be one of your most valuable tools to reach your goals because it will increase your awareness and help you change. Complete the diary as frequently as possible. It is worth the effort!

Food and Beverages 1.Inthetopsectionofthediary:

• Writeyournameandthedate.• Fillinyourdailycaloriegoal.Use

thischarttoselectyourcalories.• Setaweeklyfoodgoaltoimprove

yourdiet.Example:“I will cut down on calories by eliminating snacking while watching TV in the evenings this week,” or “I will drink water or sugar-free beverages in place of regular soda this week.”

2.Weighyourselfdailyandrecordyourweightintheheaderrow,nexttotheday.

3.Writedowneverythingyoueatanddrink,andtheamount.Ifyouknowthemeasuredamount,listit.Ifyoudon’tknowtheexactamountthenestimatethesize(2"x1"x1"),thevolume(½cup),theweight(2ounces),and/orthenumberofitems(12)ofthattypeoffood.Includeas much detail as possible.

4.Completethelinethathas“M PC H”listed:• CircleMifyouweremindful(awareofwhat&howmuchyouate).• CirclePCifthemealwasportion-controlled(seeHandoutS06,

Making Healthy Food Choices with a Healthy Plate).• CircleHifthemealwashealthy(seeHandoutS06).• Markthenumberson1–10Hunger/Fullnessratingscale

(1=starving,5=neitherhungrynorfull,10=uncomfortablyfull)· PlaceanXoverthenumberthatrepresentsthePre-mealhunger/fullnesslevel.· DrawacirclearoundthenumberthatrepresentsthePost-mealhunger/fullnesslevel.

5.Fillinawordtodescribeyourmood(happy,content,sad,angry,lonely,excited,exhausted,bored,anxious,fearful,oranyotheremotion).

6.Useacaloriecountertoentertotalcaloriesfortheday.Purchaseabooklet,useaWebsiteoraSmartphoneApptocountcalorieseasily.

7.Attheendoftheday,circlewhetheryoumetyourgoalfortheday:• Ifyoumetyourgoal,circle“I did it!”• Ifyoualmostmetyourgoal,circle“Almost.”• Ifyoudidn’tachieveyourgoal,circle“Try again.”

Current Weight Daily Calorie Goal

Under 200 pounds 1200–1500 calories per day

200–225 pounds 1500–1800 calories per day

226–250 pounds 1800–2000 calories per day

251–300 pounds 2000–2500 calories per day

301–350 pounds 2500–3000 calories per day

Over 350 pounds See a MOVE!® Dietitian

www.move.va.gov Page 2 of 6Standard Handouts • S08 Version 5.0

Physical Activity1.Write your weekly physical activity goalonthetopline.Example:“I want to walk 15 to 30

minutes per day for 4 out of 7 days this week and do strength training twice a week. I will also look for additional ways to be active throughout the day, like taking the stairs instead of the elevator, three times a day.” RefertoHandoutS02, Set Your Weight Loss Goals,foranexplanationofhowtosetaSMARTgoal.

NOTE: You do not need to do all four types of activity each day. See below for descriptions and guidance for recommended amounts of physical activity. Refer to the sample plan to see how to spread out the types of activities over the week.

2.Aerobic activityiswhenthebody’slargemusclesmovetogetherandyourheartbeatsfasterthanusual.Examplesincludeaerobics,swimming,running,walking,kickboxing,dancing,andcycling.Thistypeofactivityburnsthemostcaloriesandpromotesweightloss.In this box,writedownwhatyoudid,howlongyoudidit,and/orthenumberofsteps/wheelchairrevolutions.

3.Strengthening activityiswhenthebody’smusclesworkagainstaforceorweight.Examplesincludeelasticbands,weights,orbodyweight.In this box,writedownthetypeofstrengthtrainingandhowmanyrepetitionsandsetsofeachexerciseyouperformed.

4.Flexibility (stretching)lengthensamuscle.Thismakesamusclefeelloosewhileincreasingrangeofmotion.Examplesincludeself-stretch,yoga,Pilates,andchairstretchingroutines.In this box,writedownthetypeofstretchyouparticipatedin.

5.Lifestyle activityoccursduringnormal,everydayactivitysuchasvacuuming,walkingthedog,mowingthelawn,participatinginawalkingmeetingatwork,ordancing.

6.Recommended Amounts of Physical Activity• Aerobic:

· WeightLoss:300minutes(5hours)perweek.Startwithwhatyoucandoandbuildto300minutesovertime.

· Health/WeightMaintenance:150minutes(2½hours)perweek,inperiodsofatleast10minutes.

• Strength:Dostrengthtraining2–3times/week.Eachexerciseshouldberepeated,completing8–12repetitions.

• Flexibility/Stretching:Besuretostretchaftereachworkout,whetherit’saerobicorstrength.

• Lifestyle Activity:Getasmuchasyoucan.

7.At the end of the day, circlewhetheryoumetyourgoalfortheday:• Ifyoumetyourgoal,circle“I did it!”• Ifyoualmostmetyourgoal,circle “Almost.”• Ifyoudidn’tachieveyourgoal,circle“Try again.”

8.At the end of each day,totalyouraerobicactivity(inminutes).At the end of each week,addyourdailyaerobictotalstogethertodetermineyourweeklyaerobictime.

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Dai

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Stan

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Han

dout

s •

S08

Vers

ion

5.0

Page

4 o

f 6

Dai

ly F

ood

and

Phys

ical

Act

ivit

y D

iary

Nam

e:

D

ate:

Dai

ly C

alor

ie G

oal:

(see

instr

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ns or

Stan

dard

Han

dout

S01 f

or gu

idanc

e)

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kly

Food

Goa

l: N

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de ev

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hing y

ou ea

t and

drink

in yo

ur di

ary.

Day

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eigh

tSu

nday

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day

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sday

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ay /

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rday

/

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kfas

t(6

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0am

)

M=

Min

dful

PC=

Port

ion

Cont

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H=

Hea

lthy

Hung

er/F

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ess S

cale

X=

Pre-

mea

l

=Po

st-m

eal

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

Lunc

h(1

1am

–2pm

)

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

Din

ner

(5pm

–8pm

)

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

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d:

M

PC

H1

2 3

4 5

6 7

8 9

10

Moo

d:

M

PC

H1

2 3

4 5

6 7

8 9

10

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d:

Snac

ks &

Be

vera

ges

(bet

wee

n m

eals

)Re

mem

ber,

all s

nack

s sh

ould

be

heal

thy,

m

indf

ul a

nd p

ortio

n co

ntro

lled;

incl

ude

alco

holic

bev

erag

es

Tota

l Cal

orie

s

Goa

l Met

? I

did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

Stan

dard

Han

dout

s •

S08

Vers

ion

5.0

ww

w.m

ove.

va.g

ovPa

ge 5

of 6

ww

w.m

ove.

va.g

ov

Phys

ical

Act

ivit

y W

eekl

y G

oal:

Sund

ayM

onda

yTu

esda

yW

edne

sday

Th

ursd

ayFr

iday

Satu

rday

Aer

obic

(T

ype,

Tim

e/St

eps/

Whe

elch

air

Revo

lutio

ns)

Pedo

met

er:

Pedo

met

er:

Pedo

met

er:

Pedo

met

er:

Pedo

met

er:

Pedo

met

er:

Pedo

met

er:

Stre

ngth

Ty

pe:

Type

:Ty

pe:

Type

:Ty

pe:

Type

:Ty

pe:

Repe

titio

ns:

Repe

titio

ns:

Repe

titio

ns:

Repe

titio

ns:

Repe

titio

ns:

Repe

titio

ns:

Repe

titio

ns:

Sets

:Se

ts:

Sets

:Se

ts:

Sets

:Se

ts:

Sets

:

Flex

ibili

ty

(Typ

e)

Life

styl

e A

ctiv

ity

(Typ

e/Ti

me)

Goa

l Met

? I

did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

I did

it

Alm

ost

Tr

y ag

ain

Tota

l Wee

kly

Aer

obic

Tim

e

(# m

inut

es)

Stan

dard

Han

dout

s •

S08

Vers

ion

5.0

Page

6 o

f 6