Shape Up America!
Daily Food and Activity Diary
Date: www.shapeup.org
Food Diary: Record what and how much you eat or drink throughout the day. Put an "X" in the box to track when you eat. Activity Diary: Record your activity and level of difficulty or intensity. Put an "X" in the box to track when you are physically active.
Morning Food Diary Morning Activity Diary
6am       
7am       
8am       
9am       
10am       
11am       
6am       
7am       
8am       
9am       
10am       
11am       
Afternoon Food Diary Afternoon Activity Diary
12pm       
1pm       
2pm       
3pm       
4pm       
5pm       
12pm       
1pm       
2pm       
3pm       
4pm       
5pm       
Evening Food Diary Evening Activity Diary
6pm       
7pm       
8pm       
9pm       
10pm       
11pm       
6pm       
7pm       
8pm       
9pm       
10pm       
11pm       
Night Food Diary Night Activity Diary
12am       
1am       
2am       
3am       
4am       
5am       
12am       
1am       
2am       
3am       
4am       
5am       
Food Notes
Time Ate Where With Whom How Hungry Mood Other Thoughts
 



Activity Notes
Time of Activity Mood (before, during, after) Improvements? (in strength, energy, fitness) Other Thoughts