How to keep a food diary in food allergy?

A food diary is a method to assess diet [4]. It involves systematically recording all meals, snacks, beverages and supplements consumed over a specified period of time, usually over several days or a week [5,6].

Keeping a food diary is a key tool in assessing and modifying eating habits. It also supports the diagnostic process for food allergies. The objectives of a detailed record of meals and drinks consumed are [3,4,5,6]:

• assessment of the energy and nutritional value of the diet – analysis of the habitual menu allows the dietitian to estimate the caloric content and macro- and micronutrient content of the patient’s daily diet,
• identification of dietary errors – regular noting of the meals consumed allows the detection of irregularities, such as excessive intake of saturated fats or fiber deficiency,
• support the diagnosis of food allergies – keeping a food diary helps identify potential allergens and the relationship between the consumption of certain products and the occurrence of allergic reactions,
• monitoring the progress of dietary therapy – the diary makes it possible to track changes in the patient’s diet, which is very important in assessing the effectiveness of dietary recommendations.

For a patient with a suspected food allergy, on the other hand, a food diary can be not only a diagnostic tool, but also a support in daily functioning. Regular records have numerous benefits, including:

• allow you to note precisely what foods were consumed before the onset of symptoms, which facilitates self-observation and identification of potential allergens,
• allow a better understanding of the body’s response by noting ailments and the timing of their onset after eating,
• make it possible to assess the effectiveness of dietary changes, including the elimination or reintroduction of suspect products,
• increase nutritional awareness,
• increase motivation to make positive changes.

A food diary should be as detailed as possible to allow a thorough analysis of the meals consumed and the body’s response. The most important elements include [3,5,6,7]:

• date and time of consumption of the meal described,
• type of meal (breakfast, second breakfast, lunch, snack, afternoon snack, dinner),
• the place where the meal was eaten (e.g., home, school, work, restaurant),
• the name of the meal or a brief description (e.g., a sandwich with yellow cheese and tomato),
• the type of food products making up the meal (e.g., whole wheat bread, yellow cheese, tomato),
• the amount of food products making up the meal (amount given in household measures, e.g., 1 tablespoon, and/or grams, e.g., 10 g),
• method of meal preparation (boiling, frying, baking),
• type of beverage consumed (e.g., tea, coffee with milk, sparkling water, juice),
• the amount of beverage consumed (amount given in home measures, e.g., 1 glass and/or gram, e.g., 200ml),
• post-meal symptoms (a detailed description of any bodily reactions, such as rash, bloating, belching, headache or other, and an indication of the duration and severity of symptoms present),
• medications and/or dietary supplements taken,
• additional comments (any relevant information, such as stress, fatigue, lack of sleep, storage conditions of the meal, freshness of the products consumed).

Keeping a food diary requires regularity and precision to make it a reliable tool in diagnosing food allergies and analyzing eating habits.

The most important rules:

1. Write down your meals as soon as you eat them – don’t put off filling the diary until later. This way you can avoid mistakes and you won’t forget to write down all the products you consumed.
2. Describe the consumed products accurately – it is worth giving details, such as the type of bread (wheat, rye, wholemeal, with seeds), the type of yogurt (dairy, oat, soy, fruit, natural, with pieces of fruit).
3. Don’t forget to list all the products used to prepare the meal, such as spices, oil, sauces.
4. Don’t leave out small products eaten between meals, such as fruits, vegetables, sweets, finger foods, chips, nuts. Each of these can be important in analyzing allergic reactions.
5. Record all drinks consumed, even if they seem insignificant, such as water, juice, coffee with milk and sugar.
6. Measure portions accurately, avoid determining “by eye.” Weighing products with a kitchen scale allows for more accurate records and avoids mistakes. It also helps you better understand household measurements, which can be useful in the future.
7. Do not try to “embellish” your menu. The food diary is supposed to reflect your habits. This is important for reliable analysis results.
8. Pay attention to details. The more details you include in the diary, the more useful it will be. With precise records, a nutritionist or doctor will be able to more accurately assess which products may be potential allergens or affect your health.

The length of time to keep a food diary depends on the purpose of its use and the specifics of the problem. It is assumed that the minimum time is 3-7 days, but in more complicated cases it is worth extending this period even to several weeks. For short-term completion of the diary, it is important that the records cover different days of the week. On the other hand, keeping records for several weeks requires regularity, which allows for increased diagnostic value. Regular consultations with a dietitian or physician allow you to adjust the timing of diary-keeping to meet your individual needs and goals [3,5,6,7].

Diet. Alicja Wujkowska 

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translation: Julia Majsiak