In the struggle to lose weight, picking up a pen might be just as useful as putting down the fork.
That’s according to a new study that found that people who kept daily food diaries lost twice as much weight or more as those who didn’t keep a tally of their meals.
Nearly 1,700 Kaiser Permanente study participants agreed to exercise and adopt a healthy diet, but those who took the extra step of keeping track of what they consumed got something of a booster charge in their weight loss.
“There’s a myth in this country now that weight loss is almost impossible and very few can lose weight,” said Victor Stevens, a researcher at Kaiser’s Center for Health Research in Portland, Ore., and co-author of the study, which appears in the August issue of the American Journal of Preventive Medicine.
“But we showed that with a simple, straightforward approach, nearly 70 percent of participants were able to lose enough weight to make significant improvements in their health.”
Overall, two-thirds of the study subjects lost nine pounds or more during the six-month study. But those who kept a food diary every day of the week dropped up to 20 pounds, more than twice as much as those who didn't record their every bite.
That held true for Julie Satterwhite, 46, a yo-yo dieter in Portland, Ore., who previously struggled to lose weight. She credits the food diary with helping her shed 30 pounds during the study and in turn being able to reduce the dosage of her high-cholesterol medication by half.
After the study ended, she continued to lose weight over an additional eight months by using the food diary on her own. All told, she lost 55 pounds, dropping from 205 pounds to her target goal of 150.
The weight loss also was good for her joints. Satterwhite has an arthritic knee, so the reduced weight on it felt like “a huge improvement,” she said.
Dieters don't want to write it down
“It had a very big impact,” Satterwhite said of the diary. “If I was walking through the kitchen and wanted to grab a cookie or a brownie, I would think twice because I knew I had to write it down.”
That was a common experience among those who kept diaries, noted Stevens. “Study participants said, ‘I thought about eating a second helping of chocolate cake but I didn’t because I didn’t want to see it in my food diary,” he said.
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The food diaries helped people see where extra calories were coming from, and also to recognize the hidden calories in familiar foods.
“For example, a bagel,” Satterwhite said. “They’re much higher in calories than you think they are.”
Karen Donato, the coordinator for overweight and obesity applications at the National Heart, Lung and Blood Institute (NHLBI) in Bethesda, Md., thinks one of the big effects of the diary is that it can help people realize when they’re just eating out of boredom or stress.
“A lot of times people do mindless eating, under stress, at their desks, bored, just eat things without thinking about it,” she said. “This strategy can help people avoid that.”
Participants were asked to keep food diaries by writing down anything they ate or drank that had calories. For those unaccustomed to calorie-counting, Stevens recommended using a calorie guide available online or in bookstores for at least the first month to help figure how much they’re consuming.
Most people only eat about 30 to 40 different things, so with a little practice, they usually quickly learn how many calories are in the food they’re eating, so they don’t have to keep looking it up every time, Stevens added.
The Kaiser study included 1,685 overweight or obese adults with an average age of 55, who were taking medication for high blood pressure or high cholesterol. They attended weekly group sessions that encouraged cutting back on calories and moderate exercise of 30 minutes per day. The participants also were encouraged to consume a low-fat, healthy diet rich in fruits and vegetables and to keep a daily food diary of what they ate.
Of the 70 percent that lost nine pounds or more, their weight was still dropping when the study ended, so it’s likely they would have continued losing even more had the program continued, the researchers said.
Satterwhite said it was easier to maintain the weight loss using the food diary than her past efforts using Slim-Fast, the Atkins high-protein regime or other fad diets.
“The difference was that it was a slower stable lifestyle change than doing some crash diet that you see on TV or read about in a magazine,” she said.
Some struggle with food diaries
But keeping track of food can pose a challenge for some, said Lora Burke, a professor of nursing and epidemiology at the University of Pittsburgh in Pennsylvania. She noted that she recently completed an unpublished study involving food diaries where some participants said it was too burdensome to record what they ate. These same participants also were the least successful in losing weight.
Based on these findings, Burke is now conducting a trial to test different approaches for keeping food diaries, such as Internet programs, personal digital recording devices and simple paper and pencil, to see which ones people find the easiest to use.
“Given the variation in how individuals adopt this strategy, we may need to promote an array of approaches for diverse groups to be successful,” she said.
Steve Mitchell is a science and medicine writer in Washington, D.C. His articles have appeared in a variety of newspapers, magazines and Web sites, including UPI, Reuters Health, The Scientist and WebMD.