The food diary as a tool for patients and physicians

In what seems like an increasingly daunting task of helping our patients and society deal with the epidemic of obesity, we are all searching for a place to start. As in other areas of clinical medicine, the logical starting point may be with the patient. What are his/her goals? Why does he/she want to lose weight? What and when does he/she currently eat? What is the nutritional and caloric quality of the diet?

In our diabetes continuing care clinic, we assess these variables with the use food diary. Although dietary recall is a quicker way to obtain this information, we find that the food diary more accurately reflects the details of a diet over several days or a week. We ask patients to record what/when/portion size of foods are eaten. We emphasize the importance of including snacks, dressings, supplements, and spreads because these may significantly influence caloric intake. Based on the food diary, we calculate caloric intake and look for possible nutritional deficiencies. We then evaluate with the patient simple changes that will significantly improve the nutritional value or reduce the total caloric intake.

It is often not difficult to find 250 "wasted" calories a day. Over the course of a week, this deficit results in a half a pound of weight loss without ever having to start a "diet."

In Practice
Date Posted: 13 April 2004