"Get The Skinny."   by Caroline J. Cederquist, M.D.

A food diary offers insights into dietary needs, solutions

   If you are what you eat, most people in America ought to be having an identity crisis. 

   That's because most people really have no idea what 
they're actually eating every day. Research shows 
that most people have an idea about what they're 
eating that is quite a bit off from the reality about 
what they're eating. 

   So one of the most effective tools we've used for 
helping people assess their weight and nutritional 
issues is the dietary diary. For some, being required 
to actually write down everything that goes into 
their mouth can be a real eye-opener. There are 
people who have looked back over a diary and 
realized they hadn't eaten a bite of fresh fruit or 
vegetable for days at a time! 

   For dieticians, a food diary is a critical part of patient 
assessment and treatment planning, but you can 
learn an awful lot about yourself, your habits and 
your needs just by keeping an honest diary for even 
a few days. 

   The key word here is "honest," and by that, we 
mean both truthful and thorough. It doesn't much 
help to only include the food you eat at meals when 
you're consuming 30 percent of your daily calories 
between meals. 

   It's important to know that a really good food diary 
will be more than just a list of foods and quantities. 
To be most helpful, it needs to include some 
additional situational data. For instance, we like 
patients to note where they were, who they were 
with, what they were doing and when they ate those 
foods. And they should note how they were feeling 
before they ate, and assess their hunger level, as 
well as noting any particular cravings they were 
having. 

   Why all that? If you keep a diary this way, you'll be 
able to look back and recognize specific habits and 
patterns that are undermining your goal of getting 
healthy. Until you write it down, you may not realize 
that every time you get together with Bob for coffee 
and a chat on Tuesdays, you end up having a 
creamy latte, and often a cookie or other treat to go 
along. That could be a few hundred extra calories 
you weren't noticing. 

   Keep an honest diary for a week and then take a look 
at it. We do a pretty thorough assessment with 
patients, but you can learn a lot about yourself just 
by considering the following questions: 

Related to what you were doing: 

   Were any of your snacks or meals taken in front of 
the television? Did you frequently nibble while 
preparing meals or clearing up afterwards? Did you 
eat while you were engaged in other activities, such 
as reading a book or working? Did you eat while 
involved in some collective activity, perhaps a lunch 
meeting at work? 

   You can look at those answers and tell whether 
you're unconsciously consuming more than you 
intended. Almost any time we're eating while doing 
something else, research shows we'll eat more. We'll 
often even eat when we're not hungry, if food is 
included as part of another activity. 

   You can limit this unconscious behavior by taking a 
set portion and sticking with it. Even if you're just 
nibbling snack mix at a party, you can put some in a 
cup and slowly work your way through that limited 
portion, rather than standing by the bowl and 
chatting and nibbling. 

Related to who you were with: 

   Looking back at your diary entries, do you notice any 
differences in the amount of food you ate when 
alone as compared to when you were with others? 
Were there any people who particularly influenced 
you to eat more than your really wanted, or kinds of 
food you didn't want, whether they did it deliberately 
or not? And were there any people who influenced 
you to eat the kinds and amounts of food you 
planned to eat to begin with? 

   Those answers might tell you that if you eat more 
when you're alone, you might be embarrassed by the 
type or amounts of food that you're eating and trying 
to hide it. If you eat more in front of others, it could 
be that you're eating out of nervousness, or to keep 
your hands busy, or to be polite. 

   If it's an issue of pleasing the host, you can usually 
explain that you are on a restricted diet and may not 
be able to eat all the foods offered. While most 
people are not comfortable explaining that they're on 
a weight-loss diet, many find it easier to explain in 
terms of the health benefits they're trying to attain, 
just briefly stating their on a restricted diet to lower 
their cholesterol or blood sugar. And other tend to 
be more supportive after such an explanation, as 
well. 

   If you're eating out of nervousness, you could try 
chewing gum and as silly as it may seem, wearing 
clothes with pockets to put your hands in. Many 
nervous nibblers find pockets a great relief. 

   You can continue to seek support from the people 
who seem to have a positive influence on your 
intake. Show them you appreciate their support and 
perhaps include them in your weight management 
strategies. 

   And if you're being undermined by someone you care 
for, try negotiating. Try to understand the situation 
from their point of view. They may not be aware 
how serious you are about managing your eating 
habits, so their "Aw, come on, you can have just 
one," may be well-meaning. Indeed, people often 
feel obligated to be dismissive about others? weight 
concerns to show they don't think negatively of their 
weight. 

   These are just a few things that we learn from food 
diaries, but you can see that having the information 
laid out clearly paints a picture that not only helps us 
understand the problem, but also gives us good 
guidance in planning the solution. 

Through Thick & Thin

   Keeping a diary can help you see more clearly. Just 
think about what you're eating and where you're 
eating it. Do you seem to eat better when you're at 
home or out of the house? When you're out of the 
house, are there some places where you ate more 
healthfully than others? A food diary helps you 
identify your good habits, too, so you can reinforce 
what you're already doing right! 

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Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physicians (the medical specialty of weight management). She specializes in lifetime weight management at the Cederquist Medical Wellness Center, her Naples, FL private practice, you can also get more information about Dr Cederquist and her 
weight management plan by visiting www.DietToYourDoor.com