Food diary for nutritional assessment

This resource was produced by dietitians at Sheffield Children’s NHS Foundation Trust. It can be used by anyone but is designed to be used by those seeing a dietitian due to having a restricted diet.

Information:

Name:

Hospital number (if known):

Date(s) completed:

Why have I been asked to complete a food diary?

This food diary has been given to you to help your dietitian see if your child is at risk of missing out on important nutrients.

Your dietitian will use the information provided to advise you on the best ways to meet your child’s food needs.

It is important to be as accurate as possible in the diary as this helps your dietitian make a more thorough and reliable assessment.

Where do I send the completed diary to?

You can print out this resource and fill in the diary, or use any notebook or piece of paper to complete the information. You can also type up the information in a Word document or note app on a smart phone. Once completed, please scan, photograph or attach it to an email and send to scn-tr.dietetics@nhs.net.

Or you can post it to:

Dietetics Department
Sheffield Children’s NHS Foundation Trust
Western Bank
Sheffield
S10 2TH

Vitamin and mineral supplements

Please use the table below to let us know about any vitamin and mineral supplements your child takes. This includes anything that has been prescribed or bought over-the-counter, whether in liquid, chewable, tablet or other form. Please give brand names.

Please let us know how often, on average, these supplements are taken each week. For example, it may only be accepted on school days or doses forgotten, so it is given fewer than 7 days each week.

How do I complete the diary?

1. Complete the diary for 3 to 4 days including 1 weekend day.
2. If possible, please complete this diary when your child is well and eating normally for them. For example, if they are unwell and have a reduced appetite please wait until their eating has returned to their normal before completing.
3. Record all foods and drinks taken. This includes planned meals and snacks, and anything else eaten or drunk outside of these times.
4. Try to complete the diary at the time to make sure you fully remember everything they eat or drink. If your child goes to school or college please contact them to ask them for this information.
5. If possible, weigh or measure the food before and after so you know exactly how much has been eaten. For example, if you served 100 grams of boiled potatoes and 25 grams are left over, this means 75 grams were eaten. Please record how much was offered and how much was eaten.
6. If it is not possible to weigh or measure the amount then please use household measures or serving sizes. For example, 1 potato waffle, 2.5 chicken nuggets, 2 egg sized potatoes or 2 tablespoons of baked beans.
7. Please give brand names of foods eaten.
8. Please give full details of foods eaten. For example, rather than writing milk please write if this is full fat, semi-skimmed or skimmed or if it is a fortified or unfortified plant milk. Include sauces such as ketchup or gravy.
9. If the food is homemade please share the recipe with us and indicate how much of the recipe was eaten by your child.

Food frequency

A food diary is just a snapshot in time and may not include all foods your child eats. Please also complete the following questionnaire.

After each question there is space for more information. In here, please give details of specific types of food your child eats, or if they used to eat any foods that they now refuse, or if there are any foods they have tried previously but you don’t currently offer them, or if your child only eats certain brands of food. Also include if your childs eat any foods occasionally but not frequently or any foods you have tried.

1. How often does your child eat fruits?

Please provide any further detail:

2. How often does your child eat vegetables?

Please provide any further detail:

3. How often does your child eat each of these protein foods?

Please provide any further details:

4. How often does your child eat food containing calcium?

Please provide any further details:

5. How often does you child eat starchy carbohydrate foods?

Please provide any further details:

6. Are there any other foods that your child will eat that haven’t been captured in the food diary or food frequency? If so, please give details.

7. Have you noticed any patterns between the foods they will eat? For example, certain textures or colours are preferred, or certain locations. If so, please give details.

What happens next?

Your dietitian will discuss the results of your food diary with you at your next appointment, or they may call you before then to discuss if necessary.