2012-06-23

The Diet Diary.

A diet diary is a tool naturopathic doctors use to take a peak at their patients' daily eating adventures.  Patients are asked to record everything they ate and drank each day, for a week. 

This is somewhat similar to the one they use at CCNM.  Found here.

Pros (of Diet Diaries):

- gets patients thinking about their diet and where their daily calories are coming from
- encourages patients to eat proper meals (because the chart is divided into breakfast, lunch, and dinner, with a spot for snacks on the side)
- allows the ND to help the patient to eat better. The diary is not something that the ND will critique, but will use as a template to make minor improvements (maybe more protein in the morning, fewer carbohydrates in this meal)
- helps address nutrient needs and/or deficiencies. The ND will be able to see if the patient is getting enough protein, fiber, vitamin C, calcium, etc, by analyzing the week's diary.
- help address water intake (a biggie; most people aren't drinking enough or don't really think about their water intake. The diary will make the patient start recording and thus thinking about H2O).
- typically, there is a spot for 'symptoms' too; meaning, if a patient eats pineapple and then has an afternoon stomach ache, or ate whole wheat toast and then felt bloated, then the doctor can begin to hypothesize some potential food sensitivities. The diary can be a starting point; sparking ideas for further health explorations.

Cons (of Diet Diaries), Part One:

- patients are consciously aware of their food being 'monitored'; they may skew their eating to 'please' their ND or may leave some things off the chart entirely. It is important to be honest with the diary and eat 'normal' during the recorded week.
- portions are often not recorded, maybe because the patient doesn't know much about portions. For example, the chart may read "spaghetti and meatballs" for dinner, but how much pasta was that? A handful or a salad bowl full? What about the meatballs? Was that 4 or 10?
- it's only a week. A week is really just a peak at a person's diet.  It's certainly better than nothing, but a month of diet recording would be ideal.

Cons (of Diet Diaries), Part Two:
(These are the things I hope to change on the diet diaries I hand-out when I am a practicing ND)

- an exercise log. What if a patient ate a salad bowl full of pasta (which seems like a lot!) but then ran 15 kilometers the next day? Or what if the patient had only salad for dinner, after the spent two hours at the gym? It is important to track activity in addition to intake to find out whether or not the patient getting enough fuel.
- a section for all drinks (coffee, pop, juice, wine, beer, herbal tea, etc, all contribute to one's diet and should be accounted for in the diary).
- number of bowel movements per day.  Some foods can promote constipation, while others make bowel movements more diarrhea-like (especially common food sensitivities, like dairy or gluten).  Bowel movements (as yucky as this sounds) is an important piece of the diet puzzle too.
- supplements should be tracked too.  Is the patient taking fish oil? Protein powder? Calcium chews?
- emotional feeling. In addition to physical symptoms (bloated, tired, headache, skin broke-out, etc) emotions should be recorded too.  Food can definitely stir-up our emotions. Did any foods make you feel satisfied, depleted, giddy, or miserable?

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