When my clients start working with me, I ask them all to complete a diet diary. Even in just one week of tracking your food and digestive symptoms, we can start to see patterns and useful data about your diet that can help shape a nutrition plan.
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When my clients start working with me, I ask them all to complete a diet diary.
Speaker:Some people wonder whether it's worth the effort and feel like it's a bit of
Speaker:an inconvenience, which I totally get.
Speaker:We are all busy and it's just another thing to do.
Speaker:However...
Speaker:After even just one week of tracking your food and digestive symptoms, we can start
Speaker:to see patterns and useful data about your diet that can help shape a nutrition plan.
Speaker:In this episode of the Inside Knowledge, I'm going to give you
Speaker:a better understanding of diet and symptom tracking for IBS.
Speaker:So you can try it for yourself at home, and you can also download my
Speaker:actual template that I use with my clients to give it a go for yourself.
Speaker:Hello, welcome to episode 6 of the Inside Knowledge.
Speaker:I am Anna Mappson.
Speaker:I'm a registered nutritional therapist working with people who've got IBS.
Speaker:Today, we're talking about diet diaries and what you can track in
Speaker:order to try to find some patterns.
Speaker:it's something I do with all my clients and I find it really important part
Speaker:of getting a better understanding about where you are, what you're
Speaker:eating on a day to day basis and any pattern in your symptoms.
Speaker:It's not just looking at your food and writing it down, although at a basic
Speaker:level, that is a good place to start.
Speaker:In this episode, I'm going to go through some things that you could track and
Speaker:I will also give you access to the template that I use with my clients.
Speaker:and I'm happy to share it with you loyal listeners of my podcast so that you can
Speaker:try some of these things at home and see now when we talk about diet diary,
Speaker:there are lots of templates out there.
Speaker:You know, you can get apps.
Speaker:What I do is a Google spreadsheet with my clients, but it doesn't really
Speaker:matter what the format is, as long as you're tracking the right information.
Speaker:One of the things I'm looking at is patterns around eating, like
Speaker:what time you're eating, how often do you eat, do you snack?
Speaker:All of these things give us really important information and if you haven't
Speaker:yet listened to the other episodes that I've previously done, then go
Speaker:back and listen to the one about when to eat, which was episode three.
Speaker:It's really focusing on timing of meals, regularity of three meals a
Speaker:day and When and how you could snack because that's really important.
Speaker:But anyway, moving on.
Speaker:So for this, what I'm looking at is how often you're eating, what you're
Speaker:eating in those snacks, if you do snack, and also is there huge gaps between.
Speaker:the food intake.
Speaker:I'll also be looking at your symptoms against the food intake and looking at
Speaker:timing of when those symptoms occur.
Speaker:So, as you will know, if you think about episode one, where I talked
Speaker:about normal digestion, when you eat something, it's not always that
Speaker:particular food that comes out of you.
Speaker:If you get an quick reaction to food and you find you're rushing
Speaker:to the toilet after meals, it's rarely that particular food which
Speaker:is actually giving you problems.
Speaker:so what we're looking at is a lag of like 24 to 48 hours for it to come through and
Speaker:That is interesting information as well.
Speaker:So how long does it take for the symptoms to hit you?
Speaker:Those things are really key as part of the diet diary tracking.
Speaker:And I'm also really looking at, like, quantities of protein, fats
Speaker:and carbs, particularly fibre.
Speaker:Like, are you anywhere near getting 30 grams of fibre a day?
Speaker:Maybe you're eating too much fibre.
Speaker:are you not eating protein for breakfast and lunch?
Speaker:Which I have to say is very common.
Speaker:These things can be really apparent when you write it all out and
Speaker:you see everything laid out.
Speaker:The other thing You could probably do at home is to look for repetition.
Speaker:So often people might eat a lot more wheat than they think, whether it's in breakfast
Speaker:cereals, sandwiches, pasta for dinner.
Speaker:You know, just thinking about how much of that fermentable carbohydrates
Speaker:that you are eating on a daily basis.
Speaker:And are you eating a lot of the same foods?
Speaker:We also might see lots of common vegetables repeated
Speaker:again and again and again.
Speaker:And this is particularly if you've got a very restrictive diet because
Speaker:you've had to eliminate lots of foods due to your IBS symptoms.
Speaker:So, if we now look at the template that I use, and you can download this so you
Speaker:can follow along or you can just write out the categories that I'm talking about
Speaker:in your own notebook and, do it offline.
Speaker:so the first thing I'm asking is...
Speaker:the day, obviously you just need to record what day it is, but
Speaker:also the first bite that you have of the day and the last bite.
Speaker:And this is giving me an idea of your eating window.
Speaker:So if you go back to episode three, you can hear a lot about time restricted
Speaker:feeding and whether it's a good idea to have long periods of time without food.
Speaker:But what I'm looking for here is, are you eating a lot during the day, or are
Speaker:you eating in a shortened time period?
Speaker:There's no set answer for what this has to be, it's just interesting information,
Speaker:so there's no correct answer, but I think it's useful to look at whether
Speaker:there's regularity across five or seven days, um, and see whether you're eating
Speaker:at regular times during the day, or perhaps you're a shift worker and you
Speaker:have to do, irregular eating patterns.
Speaker:And coming on to the food, I ask people to write down breakfast, lunch
Speaker:and dinner, snacks and drinks, again, writing down the time that you eat
Speaker:the foods and just writing literally what you've had for breakfast, you
Speaker:know, porridge with raisins and seeds and lunch, cheese sandwich, whatever.
Speaker:And then dinner, you had stir fry with some brown rice and then write down the
Speaker:types of snacks that you had as well.
Speaker:I don't ask people to weigh out the food.
Speaker:I don't find it necessary.
Speaker:I'm not specifically working with people on their weight most of the time, so we're
Speaker:not trying to control for energy intake.
Speaker:Sometimes if I feel like people might be under eating, I will ask them to
Speaker:send me pictures of the food so I can get a sense of portion sizing.
Speaker:Especially making sure that they're eating enough, because that can
Speaker:be a real trigger of IBS symptoms.
Speaker:Now the one thing that is really important to think about here.
Speaker:And I asked my clients to track is how hungry they were
Speaker:before and after each meal.
Speaker:This comes from appetite retraining that I, have borrowed from Dr.
Speaker:Helen McCarthy.
Speaker:She is a health psychologist who's written a book called
Speaker:How to Retrain Your Appetite.
Speaker:And she's Come up with a great appetite pendulum, which thinks about swinging from
Speaker:minus five when you're extremely hungry to plus five when you're very, very full.
Speaker:Now, I like to use this with my clients to get a sense of when you
Speaker:actually have hunger in the day.
Speaker:And when you eat, are you eating to the point that you're
Speaker:full, that you're satisfied?
Speaker:Or are you still actually hungry after your meals?
Speaker:I find it really interesting.
Speaker:A lot of people with IBS maybe override some of their hunger or fullness signals.
Speaker:And that can be down to dysregulation in the hunger hormone production, or it can
Speaker:just be down to behaviours and learned ways of eating that you've had to do
Speaker:over the years to manage your symptoms.
Speaker:It's really interesting to think about when you get hungry, and do you get
Speaker:to the point where you're absolutely starving, or do you just get mild
Speaker:hunger and actually you never feel hungry because you're always nibbling?
Speaker:All of those things, are really interesting.
Speaker:Interesting and useful information.
Speaker:So before each meal, I ask you to rate whether you're hungry on a scale
Speaker:of minus five to plus five, and then after the meal, how hungry were you?
Speaker:And again, this can just give you some really good pictures of your
Speaker:patterns of hunger and satiety.
Speaker:for each day as well, I also want to know about your bowel
Speaker:movements, of course, people with IBS, this is really, really key.
Speaker:I want to know how many poos you've had and also what type were
Speaker:they on the Bristol stool chart.
Speaker:in episode one, when we talked about normal digestion, I talked about the
Speaker:Bristol stool chart but essentially it's just a pictorial way of looking
Speaker:at poo and saying one is really hard pebbly constipated type poos, type
Speaker:seven really loose watery diarrhea.
Speaker:I want you to rank the poos on that scale every time you go.
Speaker:Sometimes people are going multiple times a day so you can write that
Speaker:down as well what type it was and how many you had per day.
Speaker:This is also really important information when you're thinking about patterns.
Speaker:Is it that case that you always go at the same time every
Speaker:day or is it really erratic?
Speaker:And you could go throughout the day, whenever it is, you
Speaker:never know what's happening.
Speaker:This is helpful information for me.
Speaker:And I think it can be helpful for you as well, just to get a sense of tracking
Speaker:it because it can feel erratic, but then perhaps when you track it, it's
Speaker:not as bad as you think, or it's not as, um, Unpatterned, as you think.
Speaker:now, the next section is moving on to, three specific symptoms that
Speaker:you can, come up with yourself.
Speaker:So for you, it might be the fact that you get really, really bad gas.
Speaker:That is your main symptom, or maybe it's that you get nausea.
Speaker:And that's something else you want to track.
Speaker:I have a space for three symptoms, and you can write those in and track
Speaker:them over those five or seven days.
Speaker:And that gives us a good idea of any fluctuations in the symptoms.
Speaker:For example, with say it's bloating, like, is it bad every day, all day?
Speaker:Is it the case that it just comes and goes?
Speaker:Is it related to the amount of bowel movements that you have?
Speaker:Like trying to connect the dots and see if there's any patterns.
Speaker:I'm also going to ask about your sleep.
Speaker:So what time did you go to bed?
Speaker:What time did you wake up?
Speaker:And then to rate and rank the quality of your sleep.
Speaker:This is also really important, getting enough sleep and making sure we are well
Speaker:rested is such a key way to help us feel more resilient, to reduce anxiety, which
Speaker:strengthens that brain gut connection.
Speaker:So we want to try and Give ourselves the opportunity for sleep and what I can
Speaker:see here from this element and you'll be able to notice as well is how many
Speaker:hours did you actually spend in bed?
Speaker:You know, if you don't spend eight hours in bed, then there's no way
Speaker:you're going to get eight hours sleep.
Speaker:So you need to look at the opportunity for sleep and work out whether
Speaker:you can go to bed any earlier.
Speaker:Like, are you going to bed at a consistent time as well?
Speaker:This can be a really important part of just better understanding your own.
Speaker:Health practices like outside of digestion and then other lifestyle things I'm
Speaker:also really interested in is how much daylight you've been exposed to per
Speaker:day now that might seem a little bit strange But when we are going outside
Speaker:more it's easier for us to set our circadian rhythms You know, we tend to
Speaker:spend a lot of time indoors nowadays.
Speaker:You might work inside drive to work sit in the office all day, drive home again
Speaker:and then sit inside majority of the time.
Speaker:Of course in the summer we might spend a little bit more time outside
Speaker:but we really are not exposed to the elements as we used to be.
Speaker:Now when we have access to daylight time it helps to set that wake sleep
Speaker:cycle which can get you better sleep but also it's just really good for mood
Speaker:so there's Special, light that comes from the sun, even on a cloudy day, that
Speaker:you just can't replicate with a bright indoor bulb inside your house or office.
Speaker:So, getting outside, I want you to think about whether you're
Speaker:getting less than 30 minutes a day.
Speaker:Are you getting one hour a day or more?
Speaker:Or are you getting, um, one to three hours or even four hours?
Speaker:And that would be, like, the maximum, probably, that most
Speaker:people will get in a day.
Speaker:And then...
Speaker:Thinking about other lifestyle factors, I want you to track up
Speaker:well how much exercise you did.
Speaker:Have you, been for a walk, for example?
Speaker:Have you been to the gym?
Speaker:Thinking about how much exercise you did, so description of it, maybe you
Speaker:went to, like Zumba class or CrossFit or something, and then how intense was that
Speaker:exercise, because that is also really key.
Speaker:When you do really intensive exercise, sometimes that can trigger IBS symptoms,
Speaker:or it might make you feel a little bit ill the next day or something.
Speaker:So again, we're looking for patterns.
Speaker:You had a really intense workout one day.
Speaker:The next morning, you were a bit hungry.
Speaker:Maybe you had.
Speaker:Breakfast a bit late, then you've got a flare up.
Speaker:These are the kind of patterns that we might be able to pick up.
Speaker:And then also, just on the lifestyle, I'm just asking people
Speaker:to rate their stress so that I can see their stress levels per day.
Speaker:And again, is it constantly that your eight out of 10
Speaker:stressed or does it fluctuate?
Speaker:And does that have any impact on your digestion?
Speaker:And then for women, I also ask about which day of your
Speaker:menstrual cycle you are on.
Speaker:It's a really key factor for so many women.
Speaker:you can find additional bloating around your time of your period that might not be
Speaker:digestion related, it might be hormonal.
Speaker:Sometimes people will find they get, constipated in the run up to
Speaker:their period and then get diarrhea when their bleeding actually starts.
Speaker:These kind of patterns are really important.
Speaker:What I have found over the last year or so of using this particular
Speaker:template is that People are noticing patterns around ovulation more, and
Speaker:that is often to do with the peak in oestrogen that can be as, triggering
Speaker:for IBS symptoms as the actual bleed.
Speaker:So just getting a sense of where you are in your menstrual cycle
Speaker:and what effect that might have on your digestion is also important.
Speaker:So that is what I use with my clients, before they start to work
Speaker:with me in my three month gut reset.
Speaker:And it gives me an idea of what they're eating, how they're eating, their
Speaker:stress levels, their exercise levels.
Speaker:But the majority of it, I also gather through a conversation as
Speaker:we have our initial consultation.
Speaker:But the purpose of this podcast episode was to give
Speaker:you some things to think about.
Speaker:And once you can start tracking, Some of these individual factors, you might
Speaker:find some of the things that I'm talking about in the podcast, like around
Speaker:timing of eating around diversity of your diet, those kind of things
Speaker:start to become a bit more apparent.
Speaker:And that's where you could start to make some positive changes.
Speaker:Now, I also wanted to finish just really thinking about if there's any
Speaker:negative consequences to diet tracking.
Speaker:And we see this quite a lot in terms of weight loss, where people are tracking,
Speaker:maybe tracking their macros, using something like MyFitnessPal, really trying
Speaker:to better understand how much energy they're intaking, and can start to get
Speaker:a little bit obsessed with the data and tracking, and lose touch a little bit with
Speaker:Now I don't see that as much using this kind of approach because I, like I said
Speaker:at the beginning, I don't ask people to weigh their food and to measure it and I'm
Speaker:not so interested in your energy intake unless I think that might be a problem.
Speaker:The purpose of tracking this is to look for patterns.
Speaker:If you're tracking using something like MyFitnessPal, you can get quite
Speaker:obsessed with the data, is what I've found, so that you think I'm not
Speaker:going to eat that chocolate because then I'll have to track it and log
Speaker:it and I can't be bothered to log it.
Speaker:Now for some people, That provides them with a momentary pause before eating
Speaker:that stops them eating the snack foods.
Speaker:And that can be helpful in terms of weight loss.
Speaker:The other thing I wanted to talk about is that once you start tracking something,
Speaker:there is this phenomenon called the Hawthorne effect, where as soon as you
Speaker:start tracking something, It starts to improve and that is because subconsciously
Speaker:we are trying to maybe put our best selves into the tracker and literally
Speaker:writing down the good stuff and wanting to it to look overall impressive, even
Speaker:if it's just for yourself and you're not going to show it to anyone, but you
Speaker:can actually just get some improvements.
Speaker:Just from measuring things rather than, even starting
Speaker:to make any of those changes.
Speaker:So that's something else to look out for.
Speaker:Is this actually normal?
Speaker:And that's why if you do it for like two weeks or more, you probably will
Speaker:revert back to your normal patterns instead of thinking, Oh, I'll try and
Speaker:be healthy just because I'm tracking it.
Speaker:And I want to put in a good tracker.
Speaker:The other thing is just trying to be really honest with yourself and literally
Speaker:write down everything that you're eating instead of just thinking, Oh, I won't
Speaker:write down the biscuits that I had at work or a little bit of my Children's
Speaker:food that I finished up for them.
Speaker:Those things could be the triggers.
Speaker:So we just need to get a really good picture and make sure that
Speaker:you are actually writing down everything that you've eaten.
Speaker:That's it for this week.
Speaker:Give it a go, download the tracker from my website.
Speaker:There's a link in the show notes, get tracking, see what patterns you recognize.
Speaker:And I've got an idea to potentially do a little workshop or webinar
Speaker:where if you've downloaded it, I'll get in touch with you and ask you
Speaker:if you'd like to be part of it.
Speaker:Maybe we can review people's diet diaries as a group and see where we go.
Speaker:Let me know if you'd be up for that.
Speaker:And just finally to finish, please, subscribe, like my podcast
Speaker:and leave me a little review.
Speaker:If you're finding some of these things helpful, I'd love to be
Speaker:able to reach a wider audience.
Speaker:thank you so much for the support, though, for people who have been listening.
Speaker:It's been great getting your feedback and, , thank you for listening.