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Food & Trigger Diary
This template records what you ate and what else was going on each day, so that over weeks you can see which items tend to be recorded on headache days. Important: appearing together is not proof of cause — use the page as a conversation starter with your doctor, not as a self-diagnosis tool.
Food & Trigger Diary — Daily Record
Name: ______________________
Date: ____________ · Note each meal or snack, and tick anything else that was going on today.
Pain level (your own rating): 1–2 Mild 3 Moderate 4 Severe 5 Very severe
| Meal / time | What I had (food & drink) |
|---|---|
| Breakfast | |
| Morning snack | |
| Lunch | |
| Afternoon snack | |
| Dinner | |
| Evening |
Other things going on today (tick all that apply):
Headache today?
☐ No☐ Yes — pain level 1–5: ____Started around: ____________
This template is for personal record-keeping only. It is not medical advice and does not replace consultation with a healthcare professional.
How to fill this page in
- One sheet per day. Write what you actually had — including snacks, drinks and portion size if you can — rather than what you planned to eat.
- Tick the “other things going on” boxes at the time it happens, not from memory at bedtime; same-day notes are easier to trust than reconstructions.
- The candidate list (cheese, chocolate, caffeine…) is a common starting point people tick, not a checklist of things to avoid — you are only recording, nothing else.
- Keep the finished sheets together — a stack of dated pages is the format most useful to show at an appointment, and it is what the monthly headache diary builds on if you want a day-by-day version.
Reading this diary honestly
- Record every day for at least 2–3 weeks — short stretches over-read coincidence.
- “Chocolate was noted on 4 of my 6 headache days” is a record. “Chocolate causes my headaches” is a conclusion — that step belongs to you and your clinician.
- Don’t cut out whole food groups based on this page alone; discuss it first.