Francis Tacotaco always knew that he wasn't a particularly healthy eater. But until he started keeping a food diary and writing in painstaking, sometimes embarrassing detail about everything that went into his mouth, he didn't know just how bad it was.

The Richmond man wouldn't eat just one or two thigh pieces from Kentucky Fried Chicken for dinner - he'd eat five. "I was eating six hot links in one sitting," Tacotaco said.

Tacotaco, severely overweight and diabetic at age 38, started logging his daily diet three months ago. When he saw just how much junk food he was eating, he made significant changes to his diet - cutting out some of the junk entirely or, in the case of the hot links, limiting himself to just one at a time. He's lost 22 pounds since.

New research suggests that Tacotaco's experience isn't unusual. In a Kaiser Permanente study released today, overweight people who kept daily food diaries lost up to twice as many pounds as those who didn't log every meal. The study is being published in the American Journal of Preventive Medicine.

"Nowadays, there is this notion that people can't lose weight, and that's not at all what we found," said Victor Stevens, senior investigator at Kaiser Permanente Center for Health Research in Portland, Ore., and an author of the study. "Keeping food diaries creates awareness of what you're eating. And quite honestly, most people don't know where the extra calories are coming from."

The two-year observational study followed 1,685 men and women who were trying to lose weight. All participants were asked to keep daily food diaries, and in the first six months of the study, they had lost on average about 12.5 pounds. But those who managed to log their eating seven days a week lost between 13 and 20 pounds over six months. Participants who kept no food diaries lost only about 9 pounds.

The results don't surprise many nutritionists, who compare keeping a food diary to going to confession - it holds people accountable, they say.

"My clients are a little skeptical at first when I tell them I want everything. I mean, every last thing. If they put sugar in their cup of coffee, I want to know it," said Sharon Meyer, a nutrition therapist at the Institute for Health and Healing at California Pacific Medical Center. "It's almost like having homework to turn in to the teacher. But sometimes we selectively forget that there was a cookie we munched after lunch."

Tacotaco, who is a Kaiser patient but was not a participant in the study, said he refuses to lie in his food diary.

"I don't cheat," he said. "I still eat sausages from time to time, I still eat pizza once every two weeks or so. If I eat a lot, I still write it down, so I can correct myself at the next meal. There's no point to doing it if you're going to cheat yourself."

But aside from the guilt that might come from seeing every french fry and chocolate chip cookie in writing, the truth is that most people aren't very good at paying attention to what they put in their mouth, nutritionists say. Food diaries force them to actually think about what they eat, said Meyer.

"People are quite surprised by what they find," Meyer said. "They have this idea that they're eating two or three slices of bread in a day, and then they realize they're eating six. Writing everything down brings us back to reality."

Meyer said nearly everyone is guilty of some form of mindless eating - the kind of behavior that leads to afternoon grazing in the break room at work or eating the entire large bag of movie theater popcorn before the opening credits have finished.

Among the worst offenders are moms, said Meyer. Her clients are often shocked at how much they're eating off their children's plates - bites of yogurt or applesauce, handfuls of cookies and crackers. The snacks might not seem like a lot, but the calories add up.

The good news, said Stanford University nutritionist JoAnn Hattner, is that those are also easy calories to get rid of - as long as people are aware of what they're doing.

"Food diaries just bring you into a zone where you're much more aware of portion sizes," said Hattner, who knows from experience. When her weight started creeping up recently, she logged her food and found, among other problem areas, that she was using too much olive oil when she cooked at home.

"I wasn't measuring it at all," she said. "I was just pouring it in, and it was too much. Now I just have a tablespoon handy."


USDA food diary page: diary pages:

The Daily Plate food diary page:

Food diaries

Start by deciding how to log food. Some people prefer a handheld notebook and a pen that can be pulled out anywhere, but many Web sites offer free or paid food logs. Many health care organizations also offer paper food logs to patients.

Write down everything. For example, an entry for a cup of coffee would need to include the size of the drink and how much sugar, cream or other extras went into it. Don't forget small bites throughout the day - the cookie shared with a co-worker, the spoonfuls of applesauce from a child's lunch.

Calculate calories. This can be the toughest part, especially at the beginning. Pay attention to food packaging, which often has all the information needed. For items that aren't obvious, an online calorie calculator could help. Measure foods that are being prepared at home, at least at first, to make sure the serving size is correct - most people underestimate portion sizes.

Analyze the results. Trends start showing up in the food logs after a few days or weeks, making it easier to find places to cut calories. Look for portion sizes that are too large and snacks that can be replaced with healthier foods.