Food Journal Name* First Last Email* Date* Date Format: DD slash MM slash YYYY BreakfastWhat did you eat?* Do You Feel...Bloated?*YesNo Overly Full?*YesNo Wind/Gas?*YesNo Burping?*YesNo Heart Burn?*YesNo Tired?*YesNo Lack of Focus?*YesNo Have Sweet Cravings?*YesNo Still Feel Hungry?*YesNo Anxious*YesNo Hyper/Shaky?*YesNo Pulse Increase?*YesNo Feel hungry Soon After Eating?*YesNo LunchWhat did you eat? Do You Feel...Bloated?*YesNo Tired?*YesNo Overly Full?*YesNo Wind/Gas?*YesNo Burping?*YesNo Heart Burn?*YesNo Tired?*YesNo Lack of Focus?*YesNo Have Sweet Cravings?*YesNo Still Feel Hungry?*YesNo Anxious?*YesNo Hyper/Shaky?*YesNo Pulse Increase*YesNo Feel Hungry Soon After Eating?*YesNo DinnerWhat did you eat? Do You Feel...Bloated?*YesNo Tired?*YesNo Overly Full?*YesNo Wind/Gas?*YesNo Burping?*YesNo Heartburn?*YesNo Tired?*YesNo Lack of Focus?*YesNo Have Sweet Cravings?*YesNo Still Feel Hungry?*YesNo Anxious?*YesNo Hyper/Shaky?*YesNo Pulse Increase?*YesNo Feel Hungry Soon After Eating?*YesNo Snacks and DrinksPlease list any other snacks or drinks you ate throughout the day. Δ
