Activity Journal – DAY 1

Name: _____________________  Day of Week: _____________________

Time Slot	Task/Activity	Intensity
RPE 	Mins. Physically Active	Calories per min.	Total calories	
Midnight – 
3:00 am	1.
2.
					
3:01 am – 
6:00 am	1.
2.
3.
					
6:01 am – 
9:00 am	1.
2.
3.

9:01 am – 
Noon	1.
2.
3.

12:01 pm – 
3:00 pm	1.
2.
3.

3:01 pm – 
6:00 pm	1.
2.
3.

6:01 pm – 
9:00 pm	1.
2.
3.

9:01 pm – 
Midnight	1.
2.
3.

		Total Mins. of activity		Total Calories		
Activity Journal – DAY 2

Name _____________________   Day of Week: _____________________

Time Slot	Task/Activity	Intensity
RPE 	Mins. Physically Active	Calories per min.	Total calories	
Midnight – 
3:00 am	1.
2.
					
3:01 am – 
6:00 am	1.
2.
3.
					
6:01 am – 
9:00 am	1.
2.
3.

9:01 am – 
Noon	1.
2.
3.

12:01 pm – 
3:00 pm	1.
2.
3.

3:01 pm – 
6:00 pm	1.
2.
3.

6:01 pm – 
9:00 pm	1.
2.
3.

9:01 pm – 
Midnight	1.
2.
3.

		Total Mins. of activity		Total Calories		

Nutrition Assignment 
Food Intake Log

Day One of Diet Record

Name:___________________________________________________

Diet recorded on____________________(day of week), _______________________(date)

Time of 
Day	Food or Beverage	Total Amount Eaten	Measuring Unit (cups, fl oz.,
Tsp, lbs, etc.)	
8 am	Wheat toast	2	Slices	
	Butter	1	TBSP 	
	Jam	2	TBSP	
	Orange juice	12	Oz.	

				

				

				

				

				

				

				

				

				
				
Nutrition Assignment 
Food Intake Log

Day Two of Diet Record

Name:___________________________________________________

Diet recorded on__________________(day of week),  _________________________(date)

Time of 
Day	Food or Beverage	Total Amount Eaten	Measuring Unit (cups, fl oz.,
Tsp, lbs, etc.)	
8 am	Wheat toast	2	Slices	
	Butter	1	TBSP 	
	Jam	2	TBSP	
	Orange juice	12	Oz.