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Keeping a Food Diary
One of the best tools that I have found for my patients to help them eat healthy and lose weight is keeping a food diary. Many popular diet plans have people record everything they eat and there's good research to support that when people do they eat better.

Keeping It Off
We all know that it's one thing to lose weight - and quite another to keep it off for the long term. A study funded by the National Institute of Health and published recently inJAMA (2008;299(10):1139-1148) compares two strategies people might use to help maintain their weight loss: regular personal contact with a counselor via telephone or unlimited access to an interactive weight maintenance website. Could an online program take the place of an actual human being for the purpose of helping people maintain their weight loss?

Weigh Yourself More to Weigh Less
It's not easy to lose weight and keep it off, and there's no shortage of advice on how to do it. One frequently-mentioned strategy is to weigh yourself regularly. Like a lot of weight-loss strategies, however, these recommendations for regular weigh-ins are mostly based on anecdotal evidence - not scientific study.


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Here's a Good Tool for Weight Loss: Your Camera

When my patients ask me for help with weight loss, the first thing I tell them to do is to keep a food diary. As I noted in my Real World Diet Coaching Essay on "Why You Should Keep A Food Diary," I think that keeping a food diary is a great tool for weight loss because it not only lets you see exactly how much you're eating, it also lets you assess where you might improve your diet - by getting more vegetables, for example.

The problem with keeping a written food diary, however, is that they can be extremely inaccurate. Studies vary in their estimates, but it seems that as many as half of all people keeping a food diary write down less than what they actually eat. Now, this doesn't necessarily mean that people aren't being honest. Often food diaries are filled out at the end of the day, counting on people being able to remember what they've eaten. (Be honest: after dinner tonight, are you going to remember that donut you ate in the break room this morning?)

Keeping a food diary online, on the other hand, seems to help people maintain their weight, which is why The Dr. Gourmet Diet Plan meal planner offers you a Food Diary as well as an Exercise Diary. Another tool that people seem to be using more and more is taking a photograph of their food before they eat it. Whole blogs are devoted to people's daily meals, in fact.

Consumer behavior researchers at the University of Wisconsin-Madison decided to compare keeping a written food diary with keeping a photographic diary (Int J Consumer St 2008;32(6):692-698). Would one type of diary make people want to change their eating habits more than another? Would either actually have an effect on what people ate?

In a pilot study of just 43 people, the researchers distributed film (not digital) cameras as well as paper food diaries to each person, instructing the participants to spend 1 week taking a photograph of everything they ate and also keeping a written, daily food diary.

At the start of the study the participants were interviewed, answering questions such as, "What do you typically eat on a day-to-day basis?" and "How healthy would you consider your eating habits to be?" At the close of the study the film they had taken was developed (the researchers note that digital cameras would likely have been a better choice). In an interview, the participant was asked to estimate how accurate their written record was, then they reviewed their photographic diary and their written diary with the interviewer.

While the majority of the participants actually preferred keeping a written food diary over a photographic diary, it appears that keeping a photographic diary was more accurate - and made people think twice about what they were eating before they actually ate it. "It did make me think a lot more about exactly what I was going to eat because I had to take a picture of it," one participant said. Other participants said that they chose not to have a snack or candy bar because it was "too much hassle" to record it. By contrast, the written diary allowed reflection about what the participant ate only after it had already been eaten.

What this means for you

All too often people eat on a sort of autopilot, letting their food choices be made on the fly. (Another reason to plan your meals ahead of time!) Photographing your food before you eat it can help you be more aware of what you are eating - and perhaps help you make better choices.

First posted: June 23, 2010