Name: Day 1- Date:

Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency)

Your Diet is the key to achieving your weight loss goals and your best health Fiber Grams:

Fat Loss Factor Daily Food And Exercise Log

Lunch Time:

Dinner Time:

Exercise Time:

Mid Day Snack Time: Hours Of Sleep

Night Time Snack Time: Quality Of Sleep (good) 1 2 3 (poor) Dinner Time:

Exercise Type: Exercise Quality (good) 1 2 3 (poor) Exercise Time:

Day 2- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency)

Lunch Time:

Fiber Grams:

Mid Day Snack Time: Hours Of Sleep

Night Time Snack Time: Quality Of Sleep (good) 1 2 3 (poor)

Exercise Type: Exercise Quality (good) 1 2 3 (poor)

Day 3- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency) Hours Of Sleep Quality Of Sleep (good) 1 2 3 (poor) 4 Mid Day Snack Time: Lunch Time: Dinner Time:

Fiber Grams:
Exercise Time:

Night Time Snack Time:

Exercise Type:

Exercise Quality (good) 1 2 3 (poor)

Day 4- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency) Hours Of Sleep Quality Of Sleep (good) 1 2 3 (poor) 4 Mid Day Snack Time: Lunch Time: Dinner Time:

Fiber Grams:
Exercise Time:

Night Time Snack Time:

Exercise Type:

Exercise Quality (good) 1 2 3 (poor)

Day 5- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency) Hours Of Sleep Quality Of Sleep (good) 1 2 3 (poor) 4 Mid Day Snack Time: Lunch Time: Dinner Time:

Fiber Grams:
Exercise Time:

Night Time Snack Time:

Exercise Type:

Exercise Quality (good) 1 2 3 (poor)

Day 6- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency) Hours Of Sleep Quality Of Sleep (good) 1 2 3 (poor) 4 Mid Day Snack Time: Lunch Time: Dinner Time:

Fiber Grams:
Exercise Time:

Night Time Snack Time:

Exercise Type:

Exercise Quality (good) 1 2 3 (poor)

Day 7- Date:
Breakfast Time: Meat & Dairy Vegetables & Fruits Breads, Cereals, & Grains Fats (butter, margarine, oils, etc.) Candy, Sweets, & Junk Food Water Intake (fl.oz.) Other Drinks: Mid Morning Snack Time: Snack Bowel Movements (# & Consistency) Hours Of Sleep Quality Of Sleep (good) 1 2 3 (poor) 4 Mid Day Snack Time: Lunch Time: Dinner Time:

Fiber Grams:
Exercise Time:

Night Time Snack Time:

Exercise Type:

Exercise Quality (good) 1 2 3 (poor)