Instructions for Using the

Meal Plan and Daily Food Checklist:

1. Start by selecting your calorie level based on the below chart. For example, if you would like to maintain your
body weight, find your weight range in column # 2 and use the recommended calorie level in column # 1. If you
would like to lose weight, select your weight from the ranges in column # 3 and be sure to follow the calorie level
recommended in column # 1.

2. Once you have determined your calorie level, use the Daily Food Checklist to aim for the correct number of
servings from each food group.

One serving = 1 box on your Daily Food Checklist sheet.

When you have one serving, as identified on the Quick Reference for Food Groups & Choices, check off a box on
your Daily Food Checklist and continue selecting foods for meals and snacks based on what is left. The goal is to
have all of your servings/boxes used each day but preferably no more servings/boxes than provided for your calorie
level. Make enough copies of a blank Daily Food Checklist sheet so that you will have one for each week of
your weight loss program.

3. When eating combination foods, read food labels to identify the number of servings from each food group.

Calorie Level Recommendations

Column # 1 Column # 2 Column # 3
Recommended for Maintenance of the Recommended for Weight Loss at the
Calorie Level* Following Weight Ranges Following Weight Ranges
1200 Less than 110 pounds
1400 Less than 100 pounds 110 - 130 pounds
1600 100 -120 pounds 131 - 165 pounds
1800 121 -135 pounds 166 -195 pounds
2000 136 -160 pounds 196 -235 pounds
2200 161 -190 pounds 236 -260 pounds
2400 Over 190 pounds Over 260 pounds

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
4. This plan assumes you are following the U.S. Department of Agriculture recommendations for exercise described
below:
To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate to vigorous physical
activity, beyond usual activity, at work or home on most days of the week.

To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: Engage in
approximately 60 minutes of moderate to vigorous physical activity, beyond usual activity, on most days of the
week while not exceeding caloric intake requirements.

To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily, moderately-intense physical
activity while not exceeding caloric intake requirements. Some people may need to consult with a health care
provider before participating in this level of activity.

Achieve physical fitness by including the following different types of exercise:

Cardiovascular conditioning and aerobic exercise

Stretch exercises for flexibility

Resistance exercises and strength training

5. People come in all shapes and sizes and this plan may not work for everyone. Depending on your age, gender and
activity level, your calorie needs may differ. Consult a registered dietitian for a personalized plan.

Number of
1200 1400 1600 1800 2000 2200 2400
Servings from
Calories Calories Calories Calories Calories Calories Calories
Food Groups
Milk 2 3 3 3 3 3 4
Fruit 3 3 4 4 5 5 5
Vegetable 4 4 4 5 6 6 6
Protein 5 5 6 7 7 8 8
Grain 4 5 6 7 8 9 10
Fat 2 3 3 4 4 5 6
Water 8 cups 8 cups 8 cups 8 cups 8 cups 8 cups 8 cups
The Amount of Nutrients in 1 Serving From Each Group
Carbohydrate Protein Fat
Food Group (grams) (grams) (grams) Calories
Grains 15 0-3 0-1 80
Using Food Labels
Starch: breads, cereals,
and grains, starchy When reading a food label, mark
vegetables, crackers, your Daily Food Check- list by
snacks, and beans, peas, using the following guidelines.
and lentils
15g carbohydrate* = 1 grain
Fruits 15 - - 60
serving
Milk
10-20g = 1 grain
Fat-free, low-fat, 1% 12 8 0-3 100
25-35g = 2 grain
Reduced-fat, 2% 12 8 5 120
40-50g = 3 grain
Whole 12 8 8 160
*Note: do not use label reading
Non-starchy Vegetables 5 2 - 25 for dairy, fruit, or non-starchy
Meat vegetables, use the other side
Lean - 7 0-3 45 of this page as a reference for
Medium-fat - 7 4-7 75 serving sizes.
High-fat - 7 8+ 100 7g protein = 1 protein serving
Fats - - 5 45 5g total fat = 1 fat serving

Sample Menu for 1600 Calories

Breakfast Dinner
Number of
1 cup blueberries = 1 fruit serving 1 cup skim, % or 1% fat milk = 1 milk
Servings from 1600
cup cornflakes = 1 grain serving serving
Food Groups Calories
1 cup skim, % or 1% fat milk = 1 milk 4 oz. chicken breast = 4 protein servings
1 medium baked potato (6 oz) = 2 grain Milk 3
serving
Coffee servings Fruit 4
3 Tbsp. low-fat sour cream = 1 fat serving Vegetable 4
Lunch Salad: Protein 6
Turkey sandwich 2 cup lettuce = 1 vegetable serving
2oz turkey = 2 protein servings Grain 6
1 cup mixture of green peppers,
2 slices bread = 2 grain servings Fat 3
tomatoes, onions = 1 vegetable
1 Tbsp. reduced fat mayonnaise = 1 fat serving
1 small peach = 1 fruit serving 2 Tbsp. reduced fat salad dressing =
1 cup carrots = 1 vegetable serving 1 fat
Unsweetened ice tea 1 cup strawberries = 1 fruit
Non-caloric beverage
Afternoon Snack
6 oz (2/3cup) low-fat yogurt = 1 milk serving Evening Snack
1 cup of raw vegetables = 1 vegetable 1 Small Apple = 1 fruit serving
serving 3 cups non-fat popcorn = 1 grain serving
(broccoli, cucumber red pepper) Diet pop
Quick Reference for Food Groups & Choices
Choose the number of servings from each group for the
Calorie level of your meal plan.

*Grain Fat
cup cooked cereals 1 teaspoon butter
cup unsweetened cereals 1 teaspoon margarine
1/3 cup beans and peas, cooked (kidney, white, split, 1 teaspoon oil
black-eyed) 6 almonds (dry roasted)
1/3 cup lentils, cooked 6 cashew
cup baked beans 6 pecans
cup corn 1 teaspoons peanut butter
cup peas, green (canned or frozen) 1 Tablespoon seeds
1 small potato, baked (3 oz) 2 Tablespoons half and half
cup potato, mashed 3 Tablespoons low fat sour cream
1 cup squash, winter (acorn, butternut) 2 Tablespoon low fat salad dressing
1/3 cup pasta, cooked 1 Tablespoon reduced fat mayonnaise
1/3 cup rice (white or brown), cooked
cup wild rice, cooked Milk
bagel (1 oz.) 1 cup milk (skim, 1/2%, or 1%)
English muffin 2/3 cup (6 oz.) yogurt (nonfat or low fat)
1/2 Frankfurter or hamburger bun (1 oz.)
1/2 Pita, 6 Fruit
1 slice bread (1 oz.) 1 small piece of fresh fruit (4 oz.)
8 animal crackers 2 Tablespoons dried fruit
3 cups popcorn (popped, no fat added) 1 cup melon
3/4 oz. pretzels (about 10 small twists) 1 cup berries
6 saltine-type crackers 1/2 cup canned fruit or juice
Protein
1 oz. of chicken, fish, beef, pork
Vegetable - non-starchy
1/2 cup cooked
1/4 cup cottage cheese
1 cup raw
1 whole egg
2 cups leafy
2 egg whites
1 oz. cheese Serving Estimator
4 oz. or 1/2 cup Tofu
1 1/2 oz. soy based sausage patties 3 oz. potato = size of a computer mouse
cup edamame 1/2 cup = size of the bulb part of a light bulb
1 Tablespoon peanut butter 1 small piece of fruit = size of a baseball
1 Tablespoon = size of a thumb tip
See the American Heart Associations website Healthy 1 ounce meat = size of 1 thin slice of deli meat
Lifestyle section for more diet tips and recommendations. 1 ounce cheese = size of two 9 volt batteries
Americanheart.org
*Use of labels is more accurate than general estimates from the grain list. Use labels when possible, see Table 2.

Disclaimer of Warranties and Limitation of Liability: The contents of this program and toolkit are provided to you for educational and
informational purposes only, on an as-is basis, without warranty of any kind. The program and toolkit content is neither intended nor shall be
deemed by you to be medical advice and is not necessarily the view of Blue Cross Blue Shield of Michigan. Always consult your physician
before starting any exercise or diet program. Blue Cross Blue Shield of Michigan expressly disclaims any and all warranties, express or
implied, including warranties of merchantability and fitness for a particular purpose. Blue Cross Blue Shield of Michigan disclaims and you
release Blue Cross Blue Shield of Michigan from any and all damages, regardless of legal theory, that may be incurred by you from this
programs and toolkits content. By viewing or accessing this program and toolkit, you acknowledge that you are bound by this Disclaimer
of Warranties and Limitation of Liability.

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Daily Food Checklist
Choose calorie level column and check boxes
to track number of servings eaten each day of the week.
1200 Cal. 1400 Cal 1600 Cal 1800 Cal Intake Log
Monday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Tuesday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Wednesday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Thursday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Friday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Saturday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn
Sunday Milk nn nnn nnn nnn
Fruit nnn nnn nnnn nnnn
Vegetable nnnn nnnn nnnn nnnnn
Protein nnnnn nnnnn nnnnnn nnnnnnn
water Grain nnnn nnnnn nnnnnn nnnnnnn
Fat nn nnn nnn nnnn

2000 to 2400 Cal continued on next page

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Daily Food Checklist
Choose calorie level column and check boxes
to track number of servings eaten each day of the week.
2000 Cal. 2200 Cal 2400 Cal Intake Log
Monday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Tuesday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Wednesday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Thursday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Friday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Saturday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn
Sunday Milk nnn nnn nnnn
Fruit nnnnn nnnnn nnnnn
Vegetable nnnnnn nnnnnn nnnnnn
Protein nnnnnnn nnnnnnnn nnnnnnnn
water Grain nnnnnnnn nnnnnnnnn nnnnnnnnnn
Fat nnnn nnnnn nnnnnn

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
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