By Michael Dansinger, MD
Have you ever kept a food record? Why would someone do that? I ask all my patients to keep food records. For years I tried to help patients meet their health goals without requiring a food record, because food records require time and effort. However, I was never able to achieve the kind of results I wanted as a lifestyle coach until I started insisting on food records. My patients started losing excess weight much more reliably and had much better chance of reversing their type 2 diabetes or prediabetes once I embraced this fundamental principle.
Every patient I see who has achieved success has kept a food record and taken it seriously, while just about every patient who has declined to keep a food record has failed to achieve satisfactory results. In my view recording food intake is practically a prerequisite to success. I know there are individuals out there who are exceptions, but for the most part this holds true.
What is it about keeping a food record that makes such a difference? There are several reasons.
Reason 1: Keeping a food record raises self-awareness. The act of keeping the record forces one to think consciously about WHAT food is being eaten and HOW MUCH of that food is being eaten. Did you drink 1 cup of orange juice or 3 cups? That would go into the food record.
Reason 2: Another reason is because the food record can be used for counting. Whether you’re counting calories, carbohydrate grams, fat grams, or something else, the process of counting takes the entire process to the next level of awareness. How many calories were in those 3 cups of orange juice? That would go into the food record. If you’re trying to lose weight or maintain a weight loss, the process of counting and then comparing your 7-day calorie average (or average carb grams, or fat grams, or other) to your weekly weight change, is a powerful technique for linking your food intake to your weight. Put another way, if you are counting something then you can “budget” what you’re counting. If you know your calorie intake, then you can budget your calories (or carbs or fat grams, etc.), allowing you to adjust your rate of food intake or total daily intake according to your weight loss or other health goal.
Reason 3: The next reasons have to do with coaching. Working with a nutrition and lifestyle coach can provide accountability, information, and encouragement. However, without keeping a food record, the coach can’t really know what the patient/client/participant is eating. The coach must know what the patient is eating, and even if the patient can remember in perfect detail what was eaten and how much, it is impossible to verbalize it efficiently. A coach needs to be able to visualize it and see the amounts and patterns. The food record is like the coach’s eyes, and without the food record the coach is blinded. Advice becomes general rather than specific without a food record. To me, as a coach, this is the most important reason to keep a food record and why I can’t do a good job without one.
Reason 4: When a patient knows a coach will be looking at the food record, and if there is a particular eating plan the patient is aiming to follow, then the food record helps “keep you honest”. Imagine you are tempted to eat a cookie (or 5 cookies). If you are keeping a food record and working with a coach, then you have 3 choices. Eat the cookies and write it down, eat the cookies and lie to your coach (and yourself), or skip the cookies and make a healthier choice. The combination of food record and coaching together force the situation of full disclosure because a patient quickly sees it is pointless to work with a coach without fully disclosing the food intake. When you know someone else is going to know about the cookies, it makes you think twice about eating them. This dynamic is extremely helpful because it provides accountability and promotes increased dietary adherence. Together the coach and patient can gage the dietary adherence level and compare that to the target adherence level.
Together, these reasons explain why a food record combined with coaching creates a driving force for better health. Without a coach, one generally doesn’t keep a food record, and without a food record, one often doesn’t get lasting results. The food intake is the main driver of success or failure to meet health goals. Unfortunately it is not human nature to police one’s own food intake, at least not to the extent of actually keeping a food record, unless someone else is going to be viewing that record. A coach can help keep you honest, help you explicitly connect your food intake to your progress, and provide specific feedback and suggestions based on your specific food intake patterns. Without a food record, none of this is possible.
In part 2, I will discuss methods for keeping a food record.