When no two of your days of eating look alike, answer the question "what do you eat on a typical day?" with the days themselves. Keep a food and drink diary, writing each day's entries on that day while you still remember them, and the doctor, nurse or dietitian who asked can read those days at your next appointment. You can keep it on paper or in an app.
What to write down, and for how many days
For each day, write down what you eat, how much, and what times of the day you are eating, and add a note on what else you were doing and how you were feeling, such as hungry, stressed, tired or bored. Include drinks as well as food, so the diary lists everything you consume in a day.
Keep it for a few days to a week, and if the person who asked about your eating named a length, use theirs.
Short entries are enough, with amounts written the way you would say them, as in these from a federal sample food and beverage diary:
| Time | Food and drink | Feelings |
|---|---|---|
| 8 a.m. | Coffee with sugar and cream, oatmeal with low-fat milk, and banana | Hungry. Ate my usual breakfast. |
| 12:30 p.m. | Roast beef and cheese sandwich on whole-wheat bread, potato chips, can of soda | Probably ate more than I was hungry for because of the "lunch deal" the deli offered me. |
| 2:30 p.m. | 1/2 chocolate bar from coworker, large coffee with sugar and cream | Feeling bored, not truly hungry. |
Calorie counts are not part of it unless the person who asked for the diary wants them. Apps on phones and tablets have become a popular way to track health habits, including what and how much people eat and drink, and if you use one, look for the app that best fits your health goals and lifestyle habits.
When the week you record is not a normal one
Keep the diary through an unusual week as well. It can help you see when you are eating a healthy diet and when you might be slipping into less healthy eating (and drinking) patterns, find out when your eating pattern is most healthy so you can try to do that more often, and discover when and how your diet could use some changes.
If something made the week unusual, such as travel or an illness, write it in the notes for the days it touched, so whoever reads the diary knows why those days look different.
The diary is not a list of the times you ate badly. Take a look at the healthy habits you have and be proud of yourself about them, and try not to judge your behaviors too harshly, because focusing only on your poor habits can make you feel stressed or give you doubts about trying to change. Use your feelings notes for good choices too, such as pride at having herbal tea instead of a snack on a night you had trouble falling asleep.
If keeping the diary starts to feel like a fixation
If keeping the diary starts to feel like a fixation, or an eating disorder is part of your history, talk to a doctor about it. Many people may be concerned about their health, weight or appearance on occasion, but some become fixated or obsessed with weight loss, body weight or shape, and controlling their food intake, and these may be signs of an eating disorder. Eating disorders are serious illnesses that can be treated successfully, and finding and treating one early is important for a full recovery.
As a NicoCares patient, tell your care team about it too, in the Spruce app whose invitation reached you by email (see A past eating disorder belongs in your weight-care medical history).
What to look for when you read the diary back
When you read the diary back, look for the same kind of day, time or feeling coming up more than once, then decide which habits you want to change. Small steps lead to more success in making long-term changes, so try not to take on too many goals: it is a good idea to limit your focus to no more than two or three at one time.
Then look for what set the eating off. Think about what triggers or prompts may be causing some of your eating habits: something around you that makes you eat when you are not hungry or leads you to choose unhealthy snacks, or the way you feel. Circle any regular or repetitive triggers in your diary. Some of these might be:
- seeing your favorite snack in the pantry or a vending machine
- watching television
- feeling stressed by something at work or in another area of your life
- having no plan for dinner after a long day
- attending events where food is served
- feeling the need for a pick-me-up toward the end of your workday
Writing down your feelings may help you identify your eating triggers: you may notice, for example, that you sometimes overeat when you are with a big group, simply because everyone around you is eating and drinking large amounts. The next time you share a meal with a group, think about your triggers and try to limit how much you eat and drink by eating more slowly. Start with the one or two triggers that occur most often, and think about what you can do to avoid them, for example:
- not walking past the vending machine to get to your desk, if you can help it
- deciding what you will have for dinner early in the day, so you have a plan after work
- keeping unhealthy snacks out of your house, and if someone else in your household buys them, finding a way to keep them out of sight
- suggesting fruits and vegetables instead of sweets at workplace meetings, or bringing healthier food for yourself
- swapping juice or soda for sparkling water
Once you have changed one or two old unhealthy habits, try changing one or two more. If you keep a record going after the first stretch, note how you felt as well as what you did, because your feelings can play a role in making new habits stick.
How to bring up your eating at the next appointment
Bring up your eating early in the next appointment by saying that you could not describe a typical day last time and have kept a diary since. Hand over the pages, or show the list in your app, with the two or three habits you chose and the triggers you circled marked, so the person reading it can find them without going through every line.
If you need help making healthier food choices, ask your doctor for help; your doctor may refer you to a registered dietitian, a health professional who helps people with healthy eating.
You can also send the two or three habits you picked to your NicoCares care team as a Spruce message. Every clinical decision about your treatment is made by independent physicians licensed in your state.
Diet counseling may be fully covered, depending on your insurance. Under the Affordable Care Act, insurance plans must cover diet counseling for people with risk factors for heart disease, like high blood pressure, and depending on your plan you may be able to get it at no cost to you, so check with your insurance company. Medicare may also cover diet counseling at no cost. If you do not have insurance, you may still be able to get free or low-cost help: search for a community health center near you on the federal Find a Health Center site and ask there about diet counseling (see Weight care is not a checkup, so the screenings are still yours to book).
