Lifestyle Log. Your name: Instructions for the Lifestyle Log:

Transcription

1 Lifestyle Log

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3 Lifestyle Log Your name: Instructions for the Lifestyle Log: Being aware of your habits is the first step in making a change in your lifestyle. Keeping track of your habits in your Lifestyle Log will make it easier for you to lose weight and develop a new, healthy lifestyle. What to do each day: Put the date at the top of the daily Food Monitoring page and check off the day of the week you are recording. Record all meals, snacks, and drinks including: time of day description of the food or drink (include all ingredients if it is a Combination Food) amount (in cups, tablespoons, slices, ounces, etc.) calories (using food labels and the Food Reference Guide) number of RED food servings you ate (using the Food Reference Guide) Add up your calories and RED food servings in the TOTAL boxes at the bottom of the daily Food Monitoring page. On the next page, record GREEN physical activity by: writing down the start and stop time writing down which GREEN physical activity you did crossing off the picture for every 10 minutes that you did it adding up the total number of minutes you were physically active Write down your family meeting time. You will keep track of specific goals that you and your PAL discuss in the Special Goals section. Have your parent or guardian sign your Log. At the end of the day: Transfer daily TOTALS from your daily logging to the Totals for the Week page, including: Calories RED food servings Minutes of GREEN Physical Activity Family meetings Special Goals (if needed) What to do each week: On the Totals for the Week page, add up the totals for: RED food servings Minutes of GREEN Physical Activity Family Meetings Special Goals (if needed) Each week, your PAL will help you set daily goals for calories, RED food servings, minutes of GREEN physical activity, and family meetings. Write down how many days you met these goals on your Totals page. Your PAL will review the information in your Lifestyle Log with you. Your PAL will record your weight at each session and sign your Log. If you used your pedometer today, record the number of steps you took. Remember to reset your pedometer each day. 1

4 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 2 Totals:

5 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 3

6 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 4 Totals:

7 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 5

8 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 6 Totals:

9 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 7

10 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 8 Totals:

11 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 9

12 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 10 Totals:

13 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 11

14 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 12 Totals:

15 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 13

16 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 14 Totals:

17 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 15

18 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 16 Totals:

19 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 17

20 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 18 Totals:

21 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 19

22 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 20 Totals:

23 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 21

24 Date: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Food Monitoring: RED Time Food Amount Calories servings 22 Totals:

25 GREEN Physical Activity Fill in each activity and draw an X on a for every ten minutes you did it! Start Time Stop Time Activity Total minutes: Record your steps from the pedometer: Family Meeting Time: AM PM Remember to reset your pedometer each day. Special Goals Parent or Guardian Signature: 23

26 Totals for the Week Date Minutes of Special RED GREEN Family Goals Calories Servings Physical Meeting Activity TOTAL: My daily goals: Number of days I met my goals: Weight change since last session: PAL signature: Minutes of RED GREEN Family Calories Servings Physical Meeting Activity (Filled in by PAL) 24

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