| 就餐地点 | 就餐时间 | 食物名称 | 食物成分 | 摄入量(g) | |
| 1 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 2 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 3 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 4 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 5 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 6 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 7 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 8 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 9 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 10 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 11 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 12 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 13 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 14 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 15 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 16 | ____________ | ____________ | ____________ | ____________ | ____________ |
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| 18 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 19 | ____________ | ____________ | ____________ | ____________ | ____________ |
| 20 | ____________ | ____________ | ____________ | ____________ | ____________ |
20题 | 被引用3次