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Food & Symptom Journal

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Food & Symptom Journal

Today's Journal

Fill this out daily, or whenever it's helpful — it helps us see the connection between what you eat and how your body responds.

Name

Date

Daily Baseline

Energy

Low Moderate High

Mood

Calm Stable Irritable Anxious Low

Sleep Quality

Poor Okay Good

Morning Routine

Water consumed before caffeine

None 8–16 oz 16–24 oz 24+ oz

How long after waking did you have caffeine?

Immediately Within 30 min 30–60 min 60+ min

Before caffeine, did you consume at least ~15g protein?

Yes No

Caffeine effects

Good energy Anxiety/jitters Crash later Increased reflux

Meal 1

Time

What did you eat

Portion Size

Small Medium Large

Protein target (~25–30g)

Met target Unsure Did not meet

Protein before carbs?

Yes No

Ate at a slower, more relaxed pace?

Yes No

Hunger before (0–10)

Fullness after (0–10)

After meal

Energized Stable Sleepy Bloated Reflux Burping/gas

Snacks / bites / extras around this meal

Meal 2

Time

What did you eat

Portion Size

Small Medium Large

Protein target (~25–30g)

Met target Unsure Did not meet

Protein before carbs?

Yes No

Ate at a slower, more relaxed pace?

Yes No

Hunger before (0–10)

Fullness after (0–10)

After meal

Energized Stable Sleepy Bloated Reflux Burping/gas

Snacks / bites / extras around this meal

Meal 3

Time

What did you eat

Portion Size

Small Medium Large

Protein target (~25–30g)

Met target Unsure Did not meet

Protein before carbs?

Yes No

Ate at a slower, more relaxed pace?

Yes No

Hunger before (0–10)

Fullness after (0–10)

After meal

Energized Stable Sleepy Bloated Reflux Burping/gas

Snacks / bites / extras around this meal

Water + Digestion

Drank large amounts of water immediately after meals?

Yes No Sometimes

Digestion today felt

Comfortable Heavy Sluggish

Symptoms

Gas Burping Acid reflux Sugar cravings Fatigue Brain fog Afternoon crash

Symptoms strongest

Morning Afternoon Evening

Timing

Immediate 1–2 hr Evening

Bowel Movement

None today Constipated Normal Loose

Felt fully eliminated?

Yes No

Supplements taken today

End of Day Reflection

Today my energy felt

More stable About the same Worse than usual

Today I felt

More in control of cravings About the same More hungry / craving sugar

Journal Received

We don't need to force your body to heal. When we understand it well enough, the healing happens on its own. You're not alone — I'm excited to see where this journey leads you.

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