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hcs_2_clinic_9
Hertfordshire Food Diary
We would like to know about everything you eat and drink for 24 hours starting the day after your interview with the nurse. Please start writing in the diary the first time after midnight that you have anything to eat or drink. Your diary should finish at midnight the next day. This is not a test, we are interested in what is a normal day for you.
Please read the next two pages carefully before beginning your diary.
If you have any questions about this diary please call us and one of our nurses will be able to help you:
How to fill in your diary:
Write down in this diary every time you have a snack, drink, or meal. Include the following:
THE TIME
THE TYPE OF FOOD OR DRINK
Use brand names where possible for example, Tesco's salt & vinegar crisps, Wall's Viennetta
For cooked food write which cooking method was used, for example: fried, deep fat fried, roast, boiled, micro-waved or baked. Also write down the brand of oil or fat used to fry/roast
If you had a home made dish, for example chilli con carne, please list the main ingredients such as mince, onions, red kidney beans, and tinned tomatoes
Don't forget that some foods are in several parts - a cheese sandwich is really three foods
2 slices white bread sandwich 1 slice Kraft cheese Flora margarine
Please say which type of milk is used each time - skimmed, semi-skimmed or whole and pasteurised (fresh), UHT, dried or condensed. For less common milks such as soya or goat's milk write as much detail as possible.
THE AMOUNT - using household measures, for example: Number of tablespoons; whether level, rounded or heaped Number of cups, mugs, bowls or slices Weight on the tin or packet, for example 150 g yogurt or 100 g bar of chocolate Number of biscuits or sweets Size, measuring the length, width and thickness (for example slice of pie, lump of cheese)
LEFTOVERS - write down anything left, for example: two crusts, skin from chicken, half the cabbage portion
SALT - write down each time salt or a salt substitute is used to cook any item and also whether salt is added to the meal at the table. Include the amount, for example, a teaspoon or a pinch
If you remember something you missed add it at the end of your diary with the time you had it
Please look at the example on the next page and then you are ready to start filling in your diary for one day
Please bring your completed diary to your follow up appointment at the clinic
Any information you provide will be kept strictly confidential
YOUR DIARY

DAY

Generic text

DATE

Generic date

Did you take any pills, tonics or tablets to supplement your diet today? (eg vitamins, minerals, fish oils)

1
Yes
2
No
Please write down the full name and brand from the bottle/packet and how many tablets or capsules or teaspoons or sachets you took
Name of product How many?
How manyGeneric textHow manyGeneric text How manyGeneric textHow manyGeneric text
1
2
3
_entry < 42

Time

Generic time

Food or drink

Generic text

Amount

Generic text

Left Over

Generic text
TURN OVER IF YOU NEED MORE SPACE
Thank you for your help
End

hcs_2_clinic_9

Hertfordshire Food Diary
We would like to know about everything you eat and drink for 24 hours starting the day after your interview with the nurse. Please start writing in the diary the first time after midnight that you have anything to eat or drink. Your diary should finish at midnight the next day. This is not a test, we are interested in what is a normal day for you.
Please read the next two pages carefully before beginning your diary.
If you have any questions about this diary please call us and one of our nurses will be able to help you:
How to fill in your diary:
Write down in this diary every time you have a snack, drink, or meal. Include the following:
THE TIME
THE TYPE OF FOOD OR DRINK
Use brand names where possible for example, Tesco's salt & vinegar crisps, Wall's Viennetta
For cooked food write which cooking method was used, for example: fried, deep fat fried, roast, boiled, micro-waved or baked. Also write down the brand of oil or fat used to fry/roast
If you had a home made dish, for example chilli con carne, please list the main ingredients such as mince, onions, red kidney beans, and tinned tomatoes
Don't forget that some foods are in several parts - a cheese sandwich is really three foods
2 slices white bread sandwich 1 slice Kraft cheese Flora margarine
Please say which type of milk is used each time - skimmed, semi-skimmed or whole and pasteurised (fresh), UHT, dried or condensed. For less common milks such as soya or goat's milk write as much detail as possible.
THE AMOUNT - using household measures, for example: Number of tablespoons; whether level, rounded or heaped Number of cups, mugs, bowls or slices Weight on the tin or packet, for example 150 g yogurt or 100 g bar of chocolate Number of biscuits or sweets Size, measuring the length, width and thickness (for example slice of pie, lump of cheese)
LEFTOVERS - write down anything left, for example: two crusts, skin from chicken, half the cabbage portion
SALT - write down each time salt or a salt substitute is used to cook any item and also whether salt is added to the meal at the table. Include the amount, for example, a teaspoon or a pinch
If you remember something you missed add it at the end of your diary with the time you had it
Please look at the example on the next page and then you are ready to start filling in your diary for one day
Please bring your completed diary to your follow up appointment at the clinic
Any information you provide will be kept strictly confidential

YOUR DIARY

DAY
Generic text
DATE
Generic date
Did you take any pills, tonics or tablets to supplement your diet today? (eg vitamins, minerals, fish oils)
1
Yes
2
No

Please write down the full name and brand from the bottle/packet and how many tablets or capsules or teaspoons or sachets you took

Name of product How many?
How manyGeneric textHow manyGeneric text How manyGeneric textHow manyGeneric text
1
2
3

_entry < 42

Time
Generic time
Food or drink
Generic text
Amount
Generic text
Left Over
Generic text
TURN OVER IF YOU NEED MORE SPACE
Thank you for your help