Name of Client / Patient: Precious Joy A.

Tobias Age: 19
Name of Interviewer: Arianne Daphne Felipe
Date of Interview: October 08, 2023

Supplements Consumed (What, When, Dose, Brand / Manufacturer):

Physical Activity (What, When, Duration, Intensity)

Total
Quantity / Amount Method of Total Protein Total Fat
Energy Content Carbohydrate
Meal Pattern Time Food / Beverage Consumed Consumed (in Preparation / Consumed Where Content Content
(in kcal) Content
household measure) Brand Name (in grams) (in grams)
(in grams)
Rice 1 cup Boiled Home 184 46 - -
Eggplant 1/2 cup Fried Home 16 3 1 -
Breakfast 7:30 A.M. Oil 1 tsp. Home 45 - - 5
3 in 1 coffee 1 cup Kopiko blanca Home 108 26 1 -
Water 1 glass Home - - - -

Camote cue 2 pcs. Home 184 46 - -

Morning
10:30 A.M. oil (camote cue) 1 tsp. Home 45 - - 5
(AM) Snack
Water 1 glass Home - - - -

Rice 1/2 cup Boiled Friend's house 92 23 - -

Scad, round (galunggong) 1 pc. Fried Friend's house 41 - 8 1
Lunch 12:30 P.M. Oil 1tsp. Friend's house 45 - - 5
Water 1 glass Friend's house - - - -

Hotdog roll 2 pcs. Fried friend's house 216 46 8 -

Oil (hotdog roll) 2 tsp. Friend's house 90 - - 10
Afternoon
3:00 P.M. Maja blanca 1 slice Friend's house 184 46 - -
(PM) Snack
Softdrinks (cola) 1 bottle Friend's house 100 25 - -

Rice 1/2 cup Boiled Home 92 23 - -

Pork Adobo 5 slices Home 565 - 40 45
Dinner 7:00 P.M. Water 1 glass Home - - - -

Bedtime (BT)
Snack
SUM 2007 284 58 71