My Favorite Assessment - Food Diary

As a Dietitian, one of the most important lessons we learn as we are studying research and

nutrition studies is, “how was the study participant’s food intake confirmed?”. There are dozens,

if not hundreds of studies on individuals under reporting their actual dietary intake and skewing

study results and findings. This is no different in the real world setting because we are

notoriously bad at remembering what we ate a few hours ago, let alone yesterday or the week

prior. One of the biggest challenges with helping individuals improve their food intake is

knowing where to start, because just giving them numbers to shoot for (ie. macros) doesn’t take

into account what they are currently doing, and doesn’t assess anything about their current

dietary habits, beliefs, nutrition skills, or schedule.

My favorite assessment tool is the 3 Day Diet Log, because this gives me a great idea of so

many different aspects of an individual’s nutrition. I like to use 3 days because just getting a 24

hour food recall (which is commonly used) can give a false appearance that an individual’s diet

is better than it actually is. This 24 hour food recall is usually done during an appointment, so

it’s heavily reliant on an individual’s memory, and sometimes the individual can overstate their

healthy diet for the sake of not wanting to look inferior in front of the Dietitian. Often in my early

years when I would collect 24 hour food recalls, the individuals would have a better diet than I

would (based on their responses), but their lab work would often tell a different story. The

results collected based on a 24 hour recall would give a picture of where to start with an

individual, but it wasn’t as accurate or as targeted as it could have been. I started using the 3

day diet log, and the plans given and results seemed to come so much easier for the individuals

and myself.

Based on a 3 Day Diet Log I can tell if an individual has planned out their meals ahead of time,

has given in to temptations at work, is a creature of habit, lacks time/cooking skill to prepare

their own meals, has a certain belief about avoiding certain foods, has an idea about

macronutrients or portion sizes, is in charge of their nutrition, eats on the go, etc. etc. This one

assessment tool can often answer so many questions about a person’s nutrition belief and

knowledge before I even sit down and chat with them about their nutrition. For the most part,

people are honest and truthful in a 3 day diet log as compared to a 24 hour food recall, so the

information I get is more accurate and shows that the individual is taking their nutrition seriously.

Even without working with a Dietitian, if people simply log their food or have a food diary, they

are more likely to see results. According to one of the largest studies on weight maintenance,

"The more food records people kept, the more weight they lost," said lead author Jack Hollis

Ph.D., a researcher at Kaiser Permanente’s Center for Health Research in Portland, Ore.

"Those who kept daily food records lost twice as much weight as those who kept no records. It

seems that the simple act of writing down what you eat encourages people to consume fewer

calories." In addition to keeping food diaries and turning them in at weekly support group

meetings, participants were asked to follow a heart-healthy DASH (a Dietary Approaches to

Stop Hypertension) diet rich in fruits and vegetables and low-fat or non-fat dairy, attend weekly

group sessions and exercise at moderate intensity levels for at least 30 minutes a day. After six

months, the average weight loss among the nearly 1,700 participants were approximately 13

pounds. More than two-thirds of the participants (69 percent) lost at least nine pounds, enough

to reduce their health risks and qualify for the second phase of the study, which lasted 30

months and tested strategies for maintaining the weight loss. "More than two-thirds of

Americans are overweight or obese. If we all lost just nine pounds, like the majority of people in

this study did, our nation would see vast decreases in hypertension, high cholesterol, diabetes,

heart disease and stroke," said study co-author Victor Stevens, Ph.D., a Kaiser Permanente

researcher. For example, in an earlier study Stevens found that losing as little as five pounds

can reduce the risk of developing high blood pressure by 20 percent. "Keeping a food diary

doesn't have to be a formal thing. Just the act of scribbling down what you eat on a Post-It note,

sending yourself e-mails tallying each meal, or sending yourself a text message will suffice. It's

the process of reflecting on what you eat that helps us become aware of our habits, and

hopefully change our behavior," says Keith Bachman, MD, a Weight Management Initiative

member. "Every day I hear patients say they can't lose weight. This study shows that most

people can lose weight if they have the right tools and support. And food journaling in

conjunction with a weight management program or class is the ideal combination of tools and

support."

Whether you log your foods yourself or enlist the help of a Dietitian to help you stay on track,

being aware of your food choices can help you reach your goals faster. At Performance EDU

we have several plans for helping you improve your nutrition and holding you accountable for

your dietary choices. If you need our help, we would be happy to look at your 3 Day Diet Log

and get started.