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Standards of Care Personal Food Guide for (space is provided to write in your name).

Description of Personal Food Guide. This table lists food groups, a description of what constitutes a single serving of representative foods in each group, number of suggested servings per day for diets targeted to people who need less food, those who need a medium amount of food, and those who need more food. Space is provided to list “My Needs” and “Personal Favorites” for each group.

The grains food group is illustrated with a photo of various breads, a bowl of rice and a floral arrangement of wheat stems. One serving of representative grain foods is: one slice of bread, ˝ bagel or bun, three or four small crackers, one small pancake or waffle, ˝ cup cooked rice or cooked noodles, one cup cold cereal or ˝ cup hot cereal. Five servings from this group are adequate for a diet of less food. Six servings from this group are adequate for a medium amount diet. Seven servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite grain foods).

The vegetables food group is illustrated with a photo of broccoli, corn and a red bell pepper. One serving of representative vegetables is: ˝ cup raw vegetables; ˝ cup cooked vegetables; 1 cup leafy vegetables, such as lettuce; 1 small baked potato (French fries do not count as a vegetable); and 3/4 cup vegetable juice. Two and one-half servings from this group are adequate for a diet of less food. Three and one-half servings from this group are adequate for a medium amount diet. Five servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite vegetables).

The fruits food group is illustrated with a photo of an apple and a banana. One serving of representative fruits is: one medium piece of fresh fruit; ˝ cup berries or fruit slices; ˝ cup canned, frozen or cooked fruit; 1/4 cup dried fruit (raisins, dried apricots); and 3/4 cup fruit juice (limit to one serving per day). Two and one-half servings from this group are adequate for a diet of less food. Three servings from this group are adequate for a medium amount diet. Four servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite fruits).

The dairy food group is illustrated with a photo of a glass of milk and a variety of cheeses. One serving of representative dairy foods is: one cup of milk; one cup of yogurt (eight ounce container); one cup of soy milk or soy yogurt; 1 ˝ ounces of cheese (this is one slice); and 1/4 cup grated cheese. Two to three servings from this group are adequate for a diet of less food. Three servings from this group are adequate for a medium amount diet. Three servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite dairy foods).

The protein food group is illustrated with a photo of a lobster, a chicken, a fish, a beefsteak, and a bowl of eggs. One serving of representative protein foods is: two to three ounces of cooked meat, chicken, or fish (about the size of the palm of the hand); two eggs; three to four tablespoons of peanut butter; one cup of cooked beans; and ˝ cup tofu or nuts. Two servings from this group are adequate for a diet of less food. Two servings from this group are adequate for a medium amount diet. Two and one-half servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite protein foods).

The extras food group is illustrated with a photo of cookies and pastries. One serving of representative extras is: one tablespoon of dressing, cream, or coffee creamer; one teaspoon of mayonnaise, butter or margarine; one small handful of potato chips or other chips; one piece of cake (the size of a cupcake); 12 ounces of soda pop; and ˝ cup of ice cream or sherbet. One serving from this group are adequate for a diet of less food. One and one-half servings from this group are adequate for a medium amount diet. Two servings from this group are adequate for a diet of more food. My needs are: (fill in the blank). Personal favorites: (list favorite extras). End of description.

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