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Angeles, Shane Aileen C.

BSN 2-2

24 Hour Dietary Recall

Instructions on Form Completion

A 24-hour recall involves asking subjects to recall and describe all the food and drink
consumed in the previous 24 hours, from waking to sleeping. A recall interview
typically requires 20 to 30 minutes to complete, but it may take considerably longer if
many different foods were consumed.
The record should include all food and drink consumed during the 24hr period
including all meals, snacks, drinks, “nibbles”, sweets etc. Your subject (or parent if
the subject is a young child) may find it easier to remember under headings such as
‘early morning’, ‘breakfast’, mid morning’, ‘mid day’, ‘mid afternoon’, ‘evening meal’,
‘late evening’ and ‘bedtime’.
If you are interested in specific foods/drinks, you should prompt more in these areas
e.g. a dentist may be interested in foods containing sugars, and the frequency with
which they are consumed.

Main Points:
1. Approximate time of eating or drinking
2. Quantity or amount eaten e.g. 6 tablespoons, 1 cup, 1 slice, etc.
3. Type of food, e.g. orange juice, chocolate, orange squash
4. Addition of ingredients during preparation and cooking, e.g. sugar / oil

In order that the record is as accurate as possible, probe further at the end of the
interview, especially if very few foods and drinks have been reported. Remember to
ask about drinks (assume one is consumed with each eating occasion) and about
late night eating, e.g. ‘Do you have anything else to eat and/or drink once you are in

Name: Sheena Allana C. Angeles

Date: 09/21/19
Day of Week (Encircle) Sun Mon Tues Wed Thurs Fri Sat

Time or Meal Food or Beverage Type of Preparation
10:10 am Rice Boiled 1 1/2 Cup
Boiled with a little bit
10:10 am Chicken 1 Cup
of oil and soy sauce
10:15 am Coffee Brewed 1 Cup
12:30 pm Water Tap 125 ml
Boiled with sauce
containing ketchup,
2:10 pm Pasta- Spaghetti 2 Cup
tomato sauce, ground
pork, sausage and oil.
Boiled with sauce
containing shrimp,
2:15 pm Pasta- Palabok 2 Cup
tinapa flakes and corn
2:15 pm Water Tap 125 ml
4:43 pm Water Tap 125 ml
5:13 pm Iced Tea Concentrated 50 ml
5:17 pm Siomai Steamed 1 Tablespoon
7:50 pm Rice Boiled 1/2 cup
7:50 pm Pasta- Pancit Canton Boiled with oil 1 cup
7:50 pm Egg Boiled 3 Tablespoon
8:00 pm White Sugar 1/4 tablespoon
Brewed with sweetener
8:06 pm Coffee 1 Cup
and creamer

Was this intake unusual? Yes___ No____

If so, how?_The client said that sometimes she barely eat food that her water intake is enough to make her

Do you take any vitamins or mineral supplements? Yes___ No____

If yes, describe:
Name or Type Dose ( if known) How often
_____________ _________________ ___________
_____________ _________________ _____________
_____________ _________________ ______________