Food and Physical Activity Record Sheet

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Food and Physical Activity Record Sheet
Source: National Institute of Child Health and Human Development, National Institutes of Health. www.nichd.nih.gov
Date
Time
Food, How it was prepared (broiled, baked, fried, or uncooked), and things you added to it (butter, salad dressing, or artificial sweetener)
Amount
Carbohydrates
Physical Activity
Time Spent
Doing Physical
Activity