1015 Mark Avenue • Carpinteria, CA 93013 © 2018 International Sports Sciences Association

1.800.892.4772 (toll-free) • 1.805.745.8111 (international)

www.ISSAonline.edu

Three-Day Dietary Record Page 1 of 4

Name Date

It is important that this record be both accurate and representative of your normal dietary intake.
Consequently, it is essential that you do not alter your normal eating habits in any way and that you
record as precisely as possible every single item that you consume (this includes water, vitamins,
condiments, margarine, etc). To do so, you must follow a few simple instructions (listed below). The
purpose here is to quantify your normal intake so do not alter your eating habits in any way or the
resulting analysis, although accurate, will be useless because it will not be representative of your typical
diet. The procedure may seem somewhat cumbersome, but remember, it is only three days.

Instructions
1. Keep a pen and paper with you at all times to record your intake including food item, quantity,
and notes. This is imperative as snacks are typically consumed unpredictably and, as a result, it is
impossible to record them accurately unless your recording forms are nearby.
2. Use a small food scale if you have one or use standard measuring devices (e.g., measuring cups,
measuring spoons) to record the quantities consumed as accurately as possible. If you do not
eat all of the item (for instance a portion of an apparently delicious hastily prepared casserole of
leftovers that turned out to be not so delicious), re-measure what’s left and record the difference.
3. Record combination foods separately (i.e., hot dog, bun, and condiments) and include brand
names of food items (list contents of homemade items) whenever possible.
4. For packaged items, use labels to determine quantities.
5. Record three days that are representative of your normal intake. Therefore if your weekdays are
different from your weekends, pick two weekdays and one weekend. Likewise, if your M, W, and F
are different from your T and Th and all these days are different from your Sat and Sun, you should
pick one day to represent each unique schedule.

Sample Dietary Record, Day 1

Food Item Quantity Notes
(include brand name) (g, ml, tablespoons [T], (include ingredients and amounts
teaspoons [t], cups [c], etc) of homemade items)

Breakfast

2 pieces toast 2 pcs Please note:

possession of
this form does
Margarine 1t not indicate that
its distributor is
actively certified
Orange Juice 6 oz with the ISSA. To
confirm certification
status, please call
Lunch 1.800.892.4772
(1.805.745.8111
international).
Small pizza 400 g pepperoni, mushroom, cheese Information
gathered from this
form is not shared
with ISSA. ISSA is
Dinner not responsible or
liable for the use
or incorporation
Chicken 6 oz of the information
contained in or
collected from
Baked Potato 6 oz this form. Always
consult your doctor
concerning your
Mixed Vegetables 1c peas, carrots, corn health, diet, and
physical activity.
 1015 Mark Avenue • Carpinteria, CA 93013 © 2018 International Sports Sciences Association
1.800.892.4772 (toll-free) • 1.805.745.8111 (international)
www.ISSAonline.edu

Three-Day Dietary Record Page 2 of 4

Name Date

Dietary Record, Day 1

Food Item Quantity Notes
(include brand name) (g, ml, tablespoons [T], (include ingredients and amounts
teaspoons [t], cups [c], etc) of homemade items)

Please note:
possession of
this form does
not indicate that
its distributor is
actively certified
with the ISSA. To
confirm certification
status, please call
1.800.892.4772
(1.805.745.8111
international).
Information
gathered from this
form is not shared
with ISSA. ISSA is
not responsible or
liable for the use
or incorporation
of the information
contained in or
collected from
this form. Always
consult your doctor
concerning your
health, diet, and
physical activity.
 1015 Mark Avenue • Carpinteria, CA 93013 © 2018 International Sports Sciences Association

1.800.892.4772 (toll-free) • 1.805.745.8111 (international)

www.ISSAonline.edu

Three-Day Dietary Record Page 3 of 4

Name Date

Dietary Record, Day 2

Food Item Quantity Notes
(include brand name) (g, ml, tablespoons [T], (include ingredients and amounts
teaspoons [t], cups [c], etc) of homemade items)

Please note:
possession of
this form does
not indicate that
its distributor is
actively certified
with the ISSA. To
confirm certification
status, please call
1.800.892.4772
(1.805.745.8111
international).
Information
gathered from this
form is not shared
with ISSA. ISSA is
not responsible or
liable for the use
or incorporation
of the information
contained in or
collected from
this form. Always
consult your doctor
concerning your
health, diet, and
physical activity.
 1015 Mark Avenue • Carpinteria, CA 93013 © 2018 International Sports Sciences Association
1.800.892.4772 (toll-free) • 1.805.745.8111 (international)
www.ISSAonline.edu

Three-Day Dietary Record Page 4 of 4

Name Date

Dietary Record, Day 3

Food Item Quantity Notes
(include brand name) (g, ml, tablespoons [T], (include ingredients and amounts
teaspoons [t], cups [c], etc) of homemade items)

Please note:
possession of
this form does
not indicate that
its distributor is
actively certified
with the ISSA. To
confirm certification
status, please call
1.800.892.4772
(1.805.745.8111
international).
Information
gathered from this
form is not shared
with ISSA. ISSA is
not responsible or
liable for the use
or incorporation
of the information
contained in or
collected from
this form. Always
consult your doctor
concerning your
health, diet, and
physical activity.