Food Journaling for Just 15 Minutes a Day Leads to Meaningful Weight Loss

Encouraging your patients to keep track of their food intake should be encouraged to promote suistainable weight loss given the easy access to online tools and smartphone apps that cut down on time.

With Jean Harvey, PhD, RD, J. Graham Thomas, PhD, J. Michael Gonzalez-Campoy, MD, PhD

For decades, researchers and providers have advised patients who wish to lose weight to keep a journal of their food intake every day. The idea of spending so much time writing down every morsel of food is likely to put most patients off, and even as they may start out strong, most will taper off.1

Yet, such advice has proven to be an effective tool in helping many individuals to achieve their weight loss goals, even as they may resent the effort.2- Even better, researchers from the University of Vermont offer evidence that advising patients to spend just 15 minutes a day logging what they eat is enough to have a significant impact on weight management. 5

Online Food Journaling proves effective in promoting sustained weight loss.

Assessing Outcomes Against Time Spent Record Food Intake Online

Jean Harvey, PhD, RD, a professor of nutrition and food science at the University of Vermont, colleagues followed a cohort of 142 individuals over 24 weeks to evaluate the efficacy of either food journaling plus behavior therapy or counseling alone in achieving sustainable weight loss.5 The researchers set out to determine the amount of time it would take to make a difference in individual weight reducing efforts.5

The research team enrolled otherwise healthy individuals (n =142) who had an elevated body mass index (BMI) between 25 and 50 kg/m2 and were already participating in the iREACH study, in which the individuals were asked to adhere to a low-calorie diet and were encouraged to exercise 200 minutes per week.

The UVM study ran parallel to the first six months of the 18-month iREACH trial, during which this cohort was instructed to keep a food log, based on the now defunct US Department of Agriculture online Supertracker.

The researchers monitored how often participants logged into their food record and the total time spent on this self-monitoring exercise with the expectation that the tool would be employed at each food occasion, requiring multiple monitoring sessions daily.

To evaluate the data, total minutes spent were correlated to the number of times participants logged in, and weight change was correlated with the number of sessions logged in. The average time spent recording food intake during the first month was 23 minutes using the online journal, and just over 14 minutes in the second month.5

“While there was no difference in weight loss among those spending more time vs. less time on the website in the first months but by the sixth month, those who lost at least 5% of body mass logged in more times and spent more time self-monitoring,” said Dr. Harvey. The consistency of daily logging correlated to greater success in weight loss over time among participants. A total of 15 minutes a day, done during at least two login sessions is enough to make a significant difference in success in weight loss efforts.

Digital Food Journaling is  Effective in Promoting Modest Weight Loss

The short amount of time required to achieve good results was an unexpected surprise and refutes the common complaint that there isn’t enough time in a day to keep a food diary. “We have known for a long time that dietary self-monitoring is one of the strongest predictors of losing weight and keeping it off,” Dr. Harvey told EndocrineWeb, “Yet it’s really hard to get people to persist with a behavior they hate to do and claim is too time-consuming. Time poverty is no longer an excuse.”

This is the first study that shows “the time spent keeping track of food intake is not overly burdensome and is effective,” said J. Michael Gonzalez-Campoy, MD, PhD, FACE, medical director and CEO of the Minnesota Center for Obesity, Metabolism and Endocrinology, in Eagan, Minnesota. “With experience in doing so, patients can effectively achieve this task in less time with good effect.”

Other studies have found that the monitoring doesn’t have to be “super detailed” to be effective,1,2,4,6 Dr. Harvey said. “What matters is doing it—be it on paper, online—whatever the patient is willing to keep doing is the best method.”

J. Graham Thomas, PhD, an associate professor of psychiatry at the Warren Alpert Medical School at Brown University in Providence, Rhode Island, believes that the lower cost and easy access to online journals and mobile device methods for self-monitoring and support make it something providers should consider promoting.

In a recent study,6 he and his team found that outcomes were as good as gold standard treatment of frequent in-person clinic visits and group programming.

“We can reach more people for less money online,” Dr. Thomas told EndocrineWeb. “That could help close the gap between results we see in gold standard in-person treatment, and online programs.” In the past, online programs just haven’t had the same success as in-person models. But what they do have is both anonymity and convenience that in-person programs and keeping paper food logs do not.

Digital Food Logs Lessen Burdens and Facilitate Immediate Feedback

“Most people have a smartphone so you don’t have to remember anything like a calorie counting book or diary or pen,” said Dr. Thomas. “And this method is more discrete, which given the stigma of weight, can help encourage some people to do something they might otherwise be embarrassed to do in public.”

Another advantage of encouraging the use of online tools—they offer more immediate feedback. “No one has to wait a week or more until the next in-person office visit to get professional guidance on food choices,” he said.

The tools often have vast databases of calorie and serving sizes, auto-complete options for frequently eaten foods, and great charts and graphs that help people make wiser choices. “You get more out of the time and energy you put into it with these online tools,” said Dr. Thomas.

Dr. Thomas and his research team are seeking to ascertain whether the frequency of using an online food journaling tool may make a difference in the amount of sustained weight loss when compared to a decrease in monitoring frequency in the non-smart phone using groups. “What I can say now is that technology does seem to help people self-monitor more often,” he said.

Patient Interaction Remains Essential for Sustained Weight Loss

While providers have long counseled patients in calorie counting and use of food diaries, the point that tracking intake alone isn’t enough. Physicians ought to recommend self-monitoring of food consumption especially at the beginning of a weight loss effort as a path to success but it must come with some time of support. “Structured behavioral support remains important. While a [food journaling] tool can be powerful, patients won’t get the most out of them within a clinical support element to the program.”

Here’s where providers have a key opportunity—to send a message “that every day is an opportunity to be healthy,” Dr. Gonzalez-Campoy told EndocrineWeb. “For them to improve on their health, change needs to happen but this change does not need to be dramatic or traumatic.”

Next up for Dr. Harvey and her team is to look at the data from these participants at 18 months, to see if early self-monitoring had an impact of significance on long term body weight outcomes.

There were no financial conflicts with regard to these studies.

 

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