How to keep a Food Diary and its benefits for Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a common disorder of the gut which can affect up to 20% of the population and cause symptoms of discomfort, bloating, diarrhoea and constipation. It can be affected by the food we eat as well as stress, anxiety and our lifestyle habits.
A food diary can help identify patterns in your eating habits which might be impacting on your symptoms. You might be surprised to learn that it’s not just what you’re eating but also how you’re eating that can worsen or calm symptoms of IBS. This guide aims to provide the knowledge needed to get started with a food diary for people experiencing gut issues such as IBS.
Why keeping a food diary for IBS might be beneficial
Positive change and improvement in symptoms tends to happen if we better understand the underlying triggers or causes. For IBS, we want to identify which eating habits and lifestyle behaviours may be affecting our gut related symptoms. Keeping a food diary alongside tracking our symptoms can give us an insight into what foods may be an issue. It also provides a way for a Doctor or a Dietitian to see a historical overview of your diet in order to provide you with the support you need to make changes.
Food allergies are relatively uncommon with IBS therefore it’s unlikely you need allergy tests. Food intolerance and sensitivity on the other hand is common. Certain foods can trigger an abnormal reaction in the gut and cause symptoms associated with IBS. High fat, highly processed and spicy foods are often a problem as well as, caffeine and alcohol. The IBS Network has additional helpful information on food intolerances including the intolerances to certain foods which are often associated with IBS. A food diary may help you notice that after eating these types of foods and drinks, your symptoms develop or worsen.
Note that if you are experiencing symptoms of IBS, it is important to discuss your symptoms in the first instance with your Doctor so that they can rule out other rare conditions such as Coeliac Disease, Inflammatory Bowel Disease (IBD) or an infection.
How does food and drink affect IBS?
The types of food we include in our diet can have a big impact on IBS symptoms. In addition to this, our eating habits, for example, how often we eat, how quickly we eat and even who we are eating with will also have an influence. Triggers vary from person to person so it is important to understand what may be a problem for you. Below is a table showing some of the most common foods and drinks which can exacerbate IBS. Some of these foods belong to the food group known as FODMAPS (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols).
FODMAPS are sugars found in some fruits, vegetables, wheat and milk and are often poorly absorbed leading to symptoms associated with IBS. It is important to remember that not all of these foods are going to be a problem and a food diary is a great tool to help identify key triggers for you so that your diet can be as varied as possible.
Some of the foods which are commonly associated with symptoms of IBS:
Wheat
Milk
Beans
Broccoli
Cauliflower
Cabbage
Brussels sprouts
Onions
Garlic
Fizzy drinks
Caffeine
Alcohol
High fat, highly processed foods
Spicy foods
Artificial sweeteners; sorbitol, mannitol, xylitol
How do I get started?
First of all you need to get yourself something to record your food diary in. What you use is totally your choice. Popular choices include phone notes, a spreadsheet or a journal.
Think about what works best for you. If you’re a visual person for instance, you can take pictures of foods or packaging to help you record important details such as portion sizes or ingredients.
You might also want to think about how quickly you are able to record what you have eaten or drunk. Some people like to record things straight away so they don’t forget important details whilst for others this may not always be feasible and they prefer to recall at the end of the day. Whichever medium you choose, it might help if you can easily carry it around with you. The Gut Feeling app allows you to easily track your food and other potential symptom triggers wherever you are.
What do I need to include in my food diary?
Your food diary should be a record of all the food and drinks that you have in a typical day. This means, where possible, noting all your meals and snacks. It’s also essential to include drinks in your food diary; this includes tea, coffee, water, milk, juices and alcohol. It is important to try and give as many details as possible to help identify patterns between your food and eating habits in relation to your symptoms.
Think about the W.W.W.H of recording in your food diary; What, When, Where and How!
1. What are you eating?
Be specific on the food and fluid you consumed e.g. a ham and lettuce sandwich on white bread with butter plus a coffee with no milk and stevia.
Is the food home cooked, a ready meal or a restaurant meal
How is it prepared or cooked e.g. baked, fried, boiled
Include marinades, spice mixes, sauces, condiments and dressings
Note down any medications, herbal remedies or vitamin and mineral supplements you are taking
2. When are you eating?
Note the time of any meals, snacks and drink consumed.
3. Where are you eating?
Record the specific place you are consuming food such as at home sitting at the kitchen table or on the sofa, at your work desk, at a party, or at a restaurant.
4. How much are you eating?
You can use teaspoons, tablespoons/grams/cups or take photos.
Record how much of the actual meal you ate.
There are some other details that you can include in your food diary if you have time as they can have strong associations with IBS symptoms:
What else are you doing whilst eating? E.g. working, watching TV or chatting to family or friends?
Why might this impact symptoms? Being distracted or rushing whilst eating may cause over-eating leading to discomfort, bloating and reflux
Who are you eating with? E.g.eating on your own or with family/children/friends/colleagues?
Why might this impact symptoms? Eating in a happy social environment with friends and family may help improve your mood and relieve stress.
What’s your mood like whilst eating? E.g. tired, bored, happy, sad, stressed, rushed or relaxed
Why might this impact on symptoms? Eating when you are bored or rushed may mean you over eat. Eating in a happy relaxed environment might mean you take time to eat slowly and enjoy your meal.
Accuracy and consistency is important so try to record what you have consumed as soon as realistically possible, this will help prevent you forgetting important details. Remember the purpose of a food diary is not to make us feel guilty about what we might or might not have eaten, but instead allows us to be aware and help take control of our gut health.
The Gut Feeling app allows you to keep track of your symptoms alongside your food diary can help to identify foods and drinks, as well as other triggers, which may be worsening your symptoms.
For how long should I keep my food diary?
Whilst keeping a food diary is a great way to try and manage your IBS symptoms, it’s not something you need to keep forever. It is recommended to keep a food diary for 24 weeks. Include all days as best you can; what you’re eating during the week, at work and weekends. You might spot some differences between these days.
So in essence try and keep a diary over a period that captures your typical and realistic eating habits. It is easy to become preoccupied with keeping a food diary so if you feel that it is affecting the way you eat or think about food in a negative way then stop and seek support from a healthcare professional.
How do I spot patterns in my food diary?
Once you start tracking your symptoms alongside keeping a food diary, it might start to become obvious that they are triggered after eating or drinking certain foods or because of specific eating habits. Take time to have a look across what you have eaten or drunk throughout your day and highlight any foods that are consistently associated with symptoms. Remember that symptoms may begin after a few minutes of eating or even the next day.
Don’t be disheartened if keeping a food diary doesn’t lead to any positive improvements in your IBS symptoms straight away. Whilst keeping a food diary can be a valuable tool, sometimes diet may not be a significant trigger. Alongside food and fluid intake, other lifestyle factors such as stress, anxiety and your level of activity and exercise are also key aspects which can have a big impact on your gut health.
What’s next after keeping a food diary?
If you need some support in making changes after keeping a food diary, you can speak with your Doctor or a specialist Dietitian for help. You also might find it helpful to read our blog on a 30 day IBS diet plan for beginners which will help give you the knowledge on how to implement dietary changes to improve your symptoms of IBS.
The Gut Feeling app is also available to download; you get access to expert led knowledge to help you find relief from your gut symptoms from less than 10 minutes a day. In the app you follow a structured programme which incorporates learning more about gut issues as well as putting tips into action. As well as access to a tool kit including yoga, meditation and recipes, you can to track your symptoms and triggers too to keep up with your progress.
Summary top tips
Sometimes our recall can be less accurate the longer we wait; try and write down any food or fluid as soon as realistically possible after you finish consuming it is so you don’t forget any important details.
Be as specific and descriptive as possible; follow the W.W.W.H method to note down volumes, portions or measurements, cooking or preparation methods and any key ingredients in the food or beverage
Include all fluid you consume, this includes alcoholic and caffeinated drinks.
Note down any medications you are taking, whether these are prescriptions or over the counter medicine, any herbal remedies and also any vitamin or mineral supplements.
Honesty is key. We all consume things in our diet that we know aren’t always the most nutritious choices. However it is important to include them in your food diary to get a true reflection of your diet.
Document your food diary in a format that works best for you; this might be in your phone notes, The Gut Feeling app, on a spreadsheet or written down in a notebook.
Remember other lifestyle factors are important too; smoking, exercise, stress and our general health will all be impacting on our gut.
To get further support on your gut health, download The Gut Feeling app for expert led advice and gut relief in just 10 minutes per day.
References
National Institute for Health and Clinical Excellence. Irritable bowel syndrome in adults. Diagnosis and management of irritable bowel syndrome in primary care. Clinical guideline 61 Update 2017 [04/04/2017]. Available from: http://www.nice.org.uk/Guidance/CG61
https://www.bda.uk.com/resource/irritable-bowel-syndrome-diet.html
https://www.theibsnetwork.org/diet/is-it-a-food-intolerance/
https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/diet-lifestyle-and-medicines/