A few years ago I read an article in the Journal of the American Dietetic Association (a poster from an ADA meeting) about a different way of doing dietary diaries. The researchers had their patients write down what they ate and photograph it with a digital camera. As you can see from the poster (reprinted in full at the bottom of this post), subjects underreported their intake in their written diaries as compared to their photographic diaries, with the biggest omissions in the written record coming from sauces and condiments.
I’ve thought about this since I read it and always thought it a good idea. Now, with almost everyone having either a small digital camera or a cell phone with a built-in camera, it makes much more sense than trying to remember everything eaten and writing it down later. And there is a huge difference between the words “two chicken thighs’ and pictures of two chicken thighs that came from KFC with all the breaded coating from their Original recipe and two chicken thighs from a rotisseried chicken. Yet, all too often, people eat the first, then simply write down ‘two chicken thighs’ and wonder why they aren’t losing weight when they review their diaries later.
A recent study has again confirmed what a lot of previous studies have shown: that people who keep diaries tend to lose substantially more weight than those who don’t. Which means that if you’re on a weight-loss program and want to really make your efforts count, you should probably keep a diet diary. And, given that they are so much more reliable, keep that diary in digital form.
I’ve decided to do that very thing for a week and publish it on this blog. I’m doing this for a couple of reasons. First, I don’t really need to lose any weight so I’m not doing it for that reason, but to answer the question people most often ask us is: What do you eat? This digital record will show everyone what we (or at least what I) eat over a week’s time.
Second, it’s easy to fool oneself. And the camera prevents that. MD and I once went to a luncheon with a lot of low-carb aficionados. At that luncheon, MD and I were the only ones who were at a normal weight – everyone else was overweight, some almost morbidly so. I listened as the waitress took orders around the table and noticed that everyone ordered a low-carb meal. Not only did they order low-carb meals, they took pains to make sure the waitress knew they didn’t want any croutons on their salads, no bread, no breading on anything, no possible hint of any added carbs to the vegetables, no carbs in the sauces, etc. The thought that went through my head at the time was that if these people ate this way all the time they wouldn’t be as overweight as they were. Had all these people been forced to examine digitally their own at-home eating, they may have been in for a big surprise.
What you see at the top of this post is my breakfast this morning, made for me by my lovely and talented wife. What you see directly below this paragraph is a photo of a Cafe Americano that I made for myself (note the wonderful crema). I drink about three or four of these before noon, one in the afternoon and a cup of decaf Americano after dinner most – but not all – nights. (Click here if you want to see me make one of these most delicious drinks.) I’m not going to photograph every cup of Americano, but I will photograph everything else that goes into my mouth. And I’m not going to try to be on my best dietary behavior like the people at the low-carb luncheon – I’m going to post photos of whatever I eat warts and all. And I’ll include any booze that I throw back, but I’m really cutting back this week in preparation for all the holiday cheer that I won’t be able to resist later in the month.
I plan to continue with my regular posting with these photo diaries interspersed. I’m going to categorize this entire week under Photo diet diary, so you can click on that to get the entire week all in one place without having to click through all the other posts.
One last thing. A few years back MD and I were guests on the new Donny and Marie show. The producers asked us to give them a list of an entire day’s worth of low-carb foods for one person. We wrote up a typical breakfast, lunch, dinner and snack menu. When we got there and got on the set all the food for an entire day was spread out on one table. I was stunned to see that much food. As Marie was talking to MD about some woman thing, I did a quick eyeball calculation and found that the food presented was what we had written in the menu. It’s one thing to see one meal’s worth of low-carb fare laid out before you, but an entire day’s is another matter. Let me tell you, it is a lot of food.
MD and I didn’t get a recording of this show, so if anyone out there happens to have it, let me know via the comments. I’ll try to talk you into letting me borrow the tape so I can digitalize it and get it up on YouTube. It’s really an amazing thing to see. And I’ll return your tape unharmed.
Below is the poster that inspired this post.
The official website of Drs. Michael and Mary Dan Eades, low carb pioneers and authors of Protein Power.
I tend to think that keeping a food diary correlates with degree of dietary restraint, rather than cause it. If you’re a half butt dieter you’re not going to write down everything you eat. If you are already very focused on your eating, you’re more likely to write it down, too. I can’t imagine any serious dieter eating 2 fried chicken thighs and honestly believing they are the same as 2 chicken thighs from a roast chicken. This suggests the person does not care about those extra calories/carbs, which reflects not caring about consistently eating in a way so as to lose or maintain weight.
If you’re the type who easily loses track of what they’ve eaten over a day, then I think a diary can help you to realize how much you’ve already eaten. Most of the time though I think we’re observing an effect, not a cause.
BTW, even writing “two breaded fried chicken thighs” isn’t good enough. If you actually weigh a chicken thigh, you’ll notice it is much heavier than these hypothetical chicken thighs in the USDA calorie bank. A large roasted chicken thigh in the bank is only about 2/3s of the calories as my large roasted chicken thighs, if I go by weight. If I enter “large chicken thigh” and do not weigh it, I underestimate calories by 100 or so.
Like people, I assume chickens have gotten bigger over the years, probably due to hormones and feeding practices.
I keep a very detailed food diary (written) but I could never do this photo stuff. I snack way too much for it to work. It would also make me feel really irritated knowing that I couldn’t eat anything without taking a picture first. It’s so easy to jot down what I eat on a piece of paper, and later enter it into my online food journal at the end of the day.
I know that my food diary is not at all necessary, but I do it only because it reflects my dietary control/organization. I am aware of everything I eat so the diary is kind of pointless.
It’s much easier for me to do this because I don’t snack much. And, I imagine, that doing it will restrict any urge I might have to snack.
I use a very useful tool for calculating my nutrient intake, the USDA Standard Reference Database (SR21), available free at http://www.ars.usda.gov/Services/docs.htm?docid=5720. Almost all the food I eat is non-packaged, but the database does list some commercial prepared foods. Using data from this tool, I developed a spreadsheet to track my daily intake. Recently, I wanted to raise my HDL by reducing PUFA and replacing them with saturated fats. Using my spreadsheet allowed me to do this without changing my daily caloric intake. By the way, I raised my HDL 10% doing this.
It is indeed a good tool. I use the online search function since I don’t think I can download the program you use into a Mac. But the data obtained is only as good as the data going in, which is probably a little more accurate coming from photos than from memory.
Dr Eades, a picture does indeed say a thousand words!
I recently took to heart Jimmy Moore challenge and been blogging my menus for the past week. I have stalled on my weight loss for a while now and decided to loose fat my low carb way, that is 5 liquid protein shakes and one full whole meal! It was going to first; make it very easily to be accountable and second; help me to only eat for physiological reasons rather then feeding my emotions and stress. Who after all heard of anyone pigging out on protein shake? Ok, that experiment lasted for about ….. a day, before I screwed it up big time. But I still managed to keep a promise and stick to low carb no matter what. I relatively did. I am back on it again and this time I do beleive its possible to accomplish. I quit smoking cold turkey, and there is no way my fat cells have a bigger grab on me than ciggarettes did!
On anohter note, I recieved my blood results back today. My doctor said everything looked perfect, accept WBC. He said my triglycerides were in 30s, my HDL went up from 35 to almost 60 and C-reactive protein was normal compared to last time when it was really high! My doctor was reluctant to finally admit low carb is working well for me, but wasnt quite sure it was good for me long term. At least he is open minded enouph not to scary me with heart attack message any more! Every time he did I used to tell him about Geaorge Burns who I once saw being interviewed by Barabar Walters before his 100 th Bday. He was smoking ciggar when BArabar asked him how long has he been doing it, and he said for years. She asked him what was his doctor thinking about him smoking and typical Gearge he replied ” I dont know he’s been dead for 20 years now. So my doctor sais it is working for me so far and unless I start getting elevated markers he would go along with my diet, like its up to him!
Dr Eades your morning menu looks like it could be a poster child for eggs, those eggs look very appetizing, but where is the beef? I know thats not all you ate today, is it? Or you havent downloaded it yet?
I haven’t posted the entire day yet. I will after I’ve eaten all I’m going to eat for the day.
Looks great so far! Cant wait to see what celebrities are eating, lol, compared to the rest of us mortals!
Since you have mentioned the ADA and diet here is some food for thought and a good reason why some are not keen about the low carb approach to diabetes. Those high carb diabetic diets are helping more than waistlines to grow.
Cost of diabetes treatment nearly doubled since 2001
Because of the increased number of patients, growing reliance on multiple medications and the shift toward more expensive new medicines, the annual cost of diabetes drugs nearly doubled in only six years, rising from $6.7 billion in 2001 to $12.5 billion in 2007 according to a study in the Oct. 27, 2008, issue of the Archives of Internal Medicine.
Since more then one-tenth of all health care expenditures in the United States in 2002 were attributable to diabetes, this finding raises important questions about whether the higher cost actually translates into improved care.
“Although more patients and more medications per patient played a role, the single greatest contributor to increasing costs is the use of newer, more expensive medications,” said lead author Caleb Alexander, MD, MS, assistant professor of medicine at the University of Chicago. “But new drugs don’t automatically lead to better outcomes.
Diabetes certainly keeps the medical cash registers ching-ching-chinging.
I record what I eat and count carbs religiously and do not have a problem with underestimating portion sizes or carbs, but have not been losing as fast as I would like. Today I figured out part of the reason why, I think.
Despite keeping carbs to 20 g. or below recently, I always have a generous amount of cream in my coffee. I was under the mistaken impression that cream was about 400 calories per cup according to nutritiondata.com. I found out this evening that it’s really around 800.
I had been looking at the caloric value for WHIPPED cream. OOPS.
I will definitely be decreasing the amount of cream in my coffee and hopefully the weight will come off faster.
Wow! You must be using a lot of cream. According to the USDA food database, heavy whipping cream contains 103 kcal per one ounce. If you are getting 800 kcal per cup, then you must be having a little coffee flavoring in each 8 oz cup of cream. Are you sure you weren’t looking at the kJ instead of the kcal when you checked your values?
I think that’s a great idea. When I first started this woe in 2004, I wrote down every little thing I ate. Sometimes it was a pain- even a little snack forgotten would skew the data. I learned quickly why FFQ’s were unreliable.
Taking a picture would really help with that. I’m not at a point where I’d need a food log anymore, but I’ll bet that if I tried it I would be surprised.
We are having more blackberries and pomegranate for dessert tonight. 🙂
Hmmm. I’m having blackberries and pomegranate arils for my dessert tonight, too.
I bet many parents would be shocked if they too photos of what their kids ate for a week!
It would certainly be an eye-opener for a lot of people.
Is there one junk carb that you absolutely hate to give up? Do you have a favorite food? I remember you said that your wife mostly chooses whats eaten and you just go along.
My favorite junk carb is pastry. Specifically, those glazed Cinnamon roles with raisins. But, I almost never eat them. If I do during this next week, I’ll take a photo.
There seems to be a lot of discussion amongst low carbers about benefit of exercise when it comes to weight loss. I just read on Jimmy Moore blog a lot of people arguing what Dr Sears said about exercise. Basically he believes that exercise is not a major part of weight loss and can really be avoided. It really robbed lots of people the wrong way. I do understand what Mr Barry was trying to say from scientific point of view. After all it takes two hours of running to burn a piece of cheesecake. But from own experience a lot of overweight people, myself included, tend to use all or nothing philosophy. If we cheat here or there we tend to feel guilty , then guilt turns into shame then shame turns into ” What a hell, i might as well go all the way now ” I call it if you burn the house you might as well burn the garage mentality! So for me personally exercise, weight training or aerobic is more like a psychological boost. It goes together like love and marriage and horse and carriage. I tend to believe that people who are exercising tend to choose food more wisely, low carb or not. I would never eat a cake right after exercise no matter how good it is! So I trully believe from my own experience as well as other overweight people that exercise has a tremendous benefit for weight loss. It is an invisible psychological tool that changes the way we eat!
What do you think? After all social support doesnt burn calories either but it has a tremendous benefit in weight loss!
I’m of the opinion that although exercise provides a multitude of health benefits, weight loss isn’t one of them.
I think somebody’s tired.:-) Monica wasn’t stating that each cup of coffee she had with cream in it was 800 kcal, but was merely pointing out that cream alone was 800 kcal/cup, instead of 400 kcal/cup as she had previously believed (which is then what you restated).
“Wow! You must be using a lot of cream. According to the USDA food database, heavy whipping cream contains 103 kcal per one ounce. If you are getting 800 kcal per cup, then you must be having a little coffee flavoring in each 8 oz cup of cream. Are you sure you weren’t looking at the kJ instead of the kcal when you checked your values?”
Heavy cream (not coffee w/cream)=103 kcal/ounce; 8 oz.=1 cup; 824 kcal/cup, yes? OR 1 T.=approx. 50 kcal, 16 T./cup=800 kcal.
All in all, I think fabulous coffee with fabulous cream is worth 100 kcal./cup.
Right you are; I must be tired. Or more likely, I’m trying to watch the football game while dealing with comments. I can barely do one thing at once, let alone two. Thanks for setting me straight.
And, just in case you’re wondering, I think fabulous coffee with fabulous cream sucks. I can’t stand cream in my coffee. Different strokes…
Dr Eades by the way going on your blog and leaving comments might not seem to help someone loose weight. But it does. Every time I go on your blog, it distracts me from eating for sure and therefore saves daily caloric intake. So when I do my digital menu blog on Jimmy Moore website I will take pic of mreades.wpengine.com web as my late night snack if you dont mind?
Go for it.
ME: “Diabetes certainly keeps the medical cash registers ching-ching-chinging.”
Caleb Alexander, MD, MS, assistant professor of medicine at the University of Chicago “But new drugs don’t automatically lead to better outcomes”.
Maybe not for the patient. But for the pharmaceutical industry’s bottom line, new diabetic drugs definitely seem to lead to better outcomes. And when MDs extol the benefits of these drugs they are most likely referring to the benefits conferred on their stock portfolios.
Cinammon roles with raisins? Oh Lord give me strength. The problem is you can stop at one and I cant. I see them every time I go mall shopping with female friends of mine. I love those mini devils ones, they usually come in box of 6. The smell alone makes me gain weight I swear. If its possibl to gain weight by smelling, by the way, is it? And thanks Katya for bringing it up, good job. Now, I really have to exercise my discipline!
And thanks for posting those wonderful pictures of food. It really looks good!
Yeah, that’s right Katy. And I do use heavy whipping cream. I think I’m going to try to make my coffee black for awhile!
Sorry I misunderstood you. I first learned to drink coffee in Europe where I drank it half coffee and half cream. I hated black coffee. But, over the years I’ve come to love black coffee, especially Americano, and dislike coffee with cream. So the switch can be done.
Dr. Eades,
Thank you very much for responding to my last post about the Allmax Protein Powder. I very highly value your opinion.
What kind of bacon do you buy? Sodium nitrite is added to all major commercially bought bacon here in Canada. However there are a few from organic stores that do not have sodium nitrite but they are rather expensive. What are your thoughts on sodium nitrite? My butcher (who’s Polish) adds some some to the bacon he makes but he says its only trace amounts. He also prepares it in the Polish traditional way using all natural and traditional processes. In Polish, the direct translation of what he adds is called “Pickling Salt” but we here know it as sodium nitrite. He claims that the sodium nitrite has always been added and is an important part of making bacon. Also, he claims (and my mom does), you can eat his bacon raw. I’d really like to continue to eat his bacon but I’m not sure that I should due to the sodium nitrite. I would appreciate your thoughts and thank you in advance.
You can safely ignore nitrites. The nitrite content of bacon is far less than the nitrite content of most vegetables. I’ve long intended to do a post on this, but have never gotten around to it. Now I don’t have to because I can link to this one. It’s just what I would have written. Enjoy. And enjoy your bacon guilt free.
regarding coffee vs. cream,
ive been trying to stay under about 30g carbs for almost a year, and i usually only eat twice a day (lunch and dinner) i dont get hungry in the morning at all, but by 11 am or so i get ravenous.
if i ate just before the usual lunch time, id get hungry by 3 or 4 and then the same thing at 9 or 10 at night. leaving me fighting off hunger or eating before bed.
so i started using heavy cream in my morning coffee and it would quell the hunger enough until my usual lunch time at 1, then id get hungry again by dinner at 6 or 7 and id be cool the rest of the night. its worked very well for me and i dont have to fight off the hunger pains at all. i assumed the fat and calories in the cream kept my hunger on ice for a bit and i havent notice any weight gain despite exercising less these days.
It will be interesting to see what you eat.
I agree that some sort of active tracking of what one eats helps in weight loss. When I lost 30 lbs. last year, I lost when I used FitDay, and stopped losing when I didn’t. I think one of the things that makes weight loss hard is maintaining the constant focus on what one eats when there is an overabundance of food everywhere one looks and the ongoing self-restraint one has to practice, given that we live in a culture that tells us it’s a mortal sin to deny ourselves anything we want. Consumption tracking aids, whether FitDay, other similar programs, or photos, really help to keep you honest and to see just how quickly what you eat adds up. I would often track first what I planned to eat for the day to see if I had to adjust portions or eliminate an ingredient, and then try to stick to the plan–and be honest if I didn’t and add in whatever else I ate.
I haven’t used FitDay since September. It gets old to meticulously assign a numeric quantity to every bite of food, including measuring it out so you are accurate and remembering to include all the extras such as how much olive oil you sauteed the vegetables in, figuring out all the quantities of everything that goes into a recipe to create a custom food, etc. I am the queen of attention to detail, but there was a point when I just thought, it’s not natural to devote all this time running the numbers on what I eat. I also gave up because I wasn’t losing anymore, so without the reward of feeling like the tracking was worth it if it helped to make the number on the scale go down, I’m taking a break from the food=numbers game. It’s Advent, which is a penitential season, so I’m watching quantities and keeping meals simple, but not actively tracking anything for now. (I hope it goes without saying that it’s all low-carb!)
Off topic for today’s post, but on yesterday’s post, JDW commented on the link between red meat and colon cancer. It seems to me that any study which attempts to link red meat to cancer would need to take into account what the cattle (from which the meat came) were fed during the 6 months before slaughter. I’d bet money that if the a study were done which looked at meat from feedlot cattle versus pastured grass fed cattle, there would be a statistical difference in the results.
The only way any of these studies could be valid is if they are randomized, controlled-trials, which would be virtually impossible to do with humans and red meat consumption. The only studies available are observational studies, and they are worthless for determining causation.
I keep a food journal. I didn’t do it for the first 6 months of low carb. I did resist the idea. I started so I could try to see patterns. This was after a small woosh of weight loss after a stall. I hoped I could figure out what caused that woosh so I could make it happen again! Did something I ate or stopped eating effect the weight loss at all? Is there a pattern to the weight loss? I don’t do any numbers – not calories, carb grams or amounts of food. I just can’t see any numbers I could figure out from FitDay or whatever would actually be any where close to reality. Plus I am just not the measuring out my food type! It was the food journal that allowed me to figure out the alcohol connection to my slowed weight loss. Hmmm….I haven’t really lost much in the last few months. What’s changed? Gee, look at all that wine! So now I limit myself to wine one night a week. I’m also experimenting with refeeds or carb ups, and the journal is helpful to see if that is helping the weight loss. Actually I would be happy if the weight loss stayed the same and I got to treat myself once a week. But it only can be seen over a period of time. And having actual records as opposed to what you THINK you remember is very helpful!
Vadim said:
“There seems to be a lot of discussion amongst low carbers about benefit of exercise when it comes to weight loss. I just read on Jimmy Moore blog a lot of people arguing what Dr Sears said about exercise. Basically he believes that exercise is not a major part of weight loss and can really be avoided. It really robbed lots of people the wrong way.”
Dr. Sears did not say that exercise “can really be avoided”. He said that exercise may account for as much as 20 percent of one’s weight control, but that diet is responsible for about 80 percent. Therefore, a poor diet can overwhelm any good exercise regimen.
In fact, if you listened to Jimmy’s interview of Barry Sears you will recall that Jimmy mentioned Fred Hahn’s “Slow Burn” regimen, to which Dr. Sears replied that he personally uses Hahn’s Slow Burn as his exercise routine. So in fact Dr. Sears does recommend exercise, not so much for weight loss, but for other benefits…such as: better overall fitness, improved sexual function, improved sleep quality, etc. And there is one way in which exercise “indirectly” may help one lose weight. That is, by increasing insulin sensitivity (and as any low carber knows, insulin is the powerhouse hormone that controls fat deposition). Insulin sensitivity is most improved with a strength training/weight lifting exercise regimen, as opposed to an aerobic/cardiovascular exercise routine–though that may have it’s benefits as well.
Dr. Eades said this:
“I’m of the opinion that although exercise provides a multitude of health benefits, *exercise*
isn’t one of them.”
Exercise isn’t a health benefit of exercise? I believe Dr. Eades meant to say “weight loss”.
P.S. A common error I frequently come across in the diet/blog world is the use of the word “loose” for “lose”. As in, “losing weight”. We lose weight, not “loose” weight. Sorry for the rant, but it’s a bit of a pet peeve.
Thanks for the great blog Dr. Eades.
Hey Paul–
Thanks for the heads up on the “exercise” for weight loss. I went back and corrected it.
I’m a big fan of exercise, too. And I’m a big fan of Slow Burn exercise specifically. But I suppose I would be, wouldn’t I?
I’m with you on the ‘loose’ wt vs ‘lose’ weight. It’s common mistake but it grates on me nevertheless.
Cheers–
MRE