Keeping A Food Diary

Everyone knows that eating less and exercising more will help you lose weight. The hard part is figuring out how to do that consistently. A study from Kaiser Permanente’s The Center for Health Research finds that one of the most important things you can do is write down what you eat.

“The more food records people kept, the more weight they lost,” says Jack Hollis PhD, a researcher at KPCHR and lead author of the study published in the August 2009 issue of the American Journal of Preventive Medicine. “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.” Download a sample food diary.

Funded by the National Heart, Lung and Blood Institute at the National Institutes of Health, the study is one of the largest and longest weight-loss maintenance trials ever conducted. It is also one of the few trials to recruit a large percentage of African Americans as study participants (44 percent). African Americans have a higher risk of conditions that are aggravated by being overweight, including diabetes and heart disease.

In addition to keeping food diaries, study participants were asked to follow the Dietary Approaches to Stop Hypertension or (DASH) diet which is high in fruits and vegetables and low in fat, 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 was 13 pounds. More than two-thirds of the participants (69%) lost at least 9 pounds, enough to lower 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 9 pounds, as most people in this study did, we would see vast decreases in hypertension, high cholesterol, diabetes, heart disease and stroke,” says Victor Stevens, PhD, study co-author and KPCHR investigator. In an earlier study, Stevens found that losing as few as five pounds can reduce by 20 % the risk of developing high blood pressure.

“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,” says Keith Bachman, MD, a Kaiser Permanente internist and weight management specialist. “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 we eat that helps us become aware of our habits, and hopefully change our behavior.”

Dr. Bachman helped to develop Kaiser Permanente’s Weight Management Initiative which recommends food journaling as a strategy for losing weight. Founded in 2002, the Weight Management Initiative unites clinicians, researchers, insurers, and policymakers to identify practical, effective, non-surgical approaches for the prevention and treatment of overweight and obesity.