Use this form to record the sodium content of the foods you eat or drink each day. This record will help you see whether you are getting too much sodium in your diet. Use the Nutrition Facts on food labels to help find how much sodium you eat.
You can tell when your body retains fluid by weighing yourself often. Sodium "attracts" fluid, so the more sodium you consume, the more fluid you will retain. When your body retains fluid, your weight may increase.
If you weigh yourself every day, you can tell when your body is retaining fluids because you will weigh more. Record the date and your weight on this form daily.
Take this record with you when you see your doctor or registered dietitian.
My doctor recommends that I have ___________milligrams (or ______ grams) of sodium in my diet each day.
Week of __________________.
|
Date and weight. |
Foods and drinks consumed during the day. |
Milligrams (or grams) of sodium in each meal or snack. |
|---|---|---|
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
|
Date:_______ Weight:_______ |
Breakfast ______________________ ______________________________ Lunch _________________________ ______________________________ Dinner _________________________ ______________________________ Snacks ________________________ ______________________________ |
Breakfast ________ Lunch ___________ Dinner ___________ Snacks ___________ Total sodium for the day: _______ |
Current as of: April 29, 2021
Author: Healthwise Staff
Medical Review:Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology & Martin J. Gabica MD - Family Medicine & Adam Husney MD - Family Medicine & George Philippides MD - Cardiology
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
To learn more about Healthwise, visit Healthwise.org.
© 1995-2021 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Síguenos
Divulgaciones
Los planes de seguro médico y dentales, tanto individuales como familiares, están asegurados por Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc. y Cigna HealthCare of North Carolina, Inc. El seguro de salud de grupo y los planes de beneficios de salud están asegurados o administrados por CHLIC, Connecticut General Life Insurance Company (CGLIC) o sus afiliados (consulta la lista de entidades legales que aseguran o administran HMO grupal, HMO dental y otros productos o servicios en tu estado). Los planes de seguro de vida universal para grupo (GUL, por sus siglas en inglés) están asegurados por CGLIC. Los planes de seguro de vida (excepto GUL), accidentes, enfermedades graves, indemnización hospitalaria y discapacidad están asegurados o administrados por Life Insurance Company of North America, excepto en NY, donde los planes asegurados los ofrece Cigna Life Insurance Company of New York (New York, NY). Todas las políticas de seguros y los planes de beneficios grupales contienen exclusiones y limitaciones. Para conocer la disponibilidad, costos y detalles completos de la cobertura, comunícate con un agente autorizado o con un representante de ventas de Cigna. Este sitio web no está dirigido a residentes de New Mexico.
Al seleccionar estos enlaces, saldrás de Cigna.com hacia otro sitio web que podría ser un sitio web externo a Cigna. Es posible que Cigna no controle el contenido ni los enlaces de los sitios web externos a Cigna. Información detallada