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posted: 9/10/2012 6:15 AM

Weighty advice: keep a journal, don't skip meals, eat in

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By Pohla Smith
Pittsburgh Post-Gazette

Keep a food journal; don't skip meals; and avoid going out to eat, especially lunch.

That's the advice suggested for postmenopausal dieters after a yearlong dietary weight-loss intervention study of 123 overweight-to-obese, sedentary women ages 50 to 75.

The findings were published online in the Journal of the Academy of Nutrition and Dietetics.

The women were randomly assigned to two arms of a controlled study headed by Dr. Anne McTiernan, director of the Fred Hutchinson Cancer Research Center's Prevention Center in Seattle, and a member of its public health sciences division. One arm of the study was diet only, and the other was exercise plus diet.

Each woman filled out questionnaires about what she was eating and drinking, what eating-related strategies she was following to lose weight, what she was doing to monitor herself and what meal patterns she had. She was asked about changes in her diet over the course of the study.

At the end, both groups lost an average of 10 percent of their starting weight, which was the goal of the intervention.

"When it comes to weight loss, evidence from randomized, controlled trials comparing different diets finds that restricting total calories is more important than diet composition, such as low-fat versus low-carbohydrate," McTiernan said. "Therefore, the specific aim of our study was to identify behaviors that supported the global goal of calorie reduction."

The findings included:

• Women who kept food journals lost about 6 pounds more than those who did not.

• Women who reported skipping meals lost almost 8 fewer pounds than women who did not.

• Women who ate out for lunch at least weekly lost on average 5 fewer pounds than those who ate out less frequently. (Eating out often at any meal time was associated with less weight loss, but the strongest association was lunch.)

"For individuals who are trying to lose weight, the No. 1 piece of advice based on these study results would be to keep a food journal to help meet daily calorie goals," McTiernan said. "It is difficult to make changes to your diet when you are not paying close attention to what you are eating."

Study participants received the following tips for keeping a food journal:

• Be honest -- record everything you eat.

• Be accurate -- measure portions, read labels.

• Be complete -- include details such as food preparation and use of toppings or condiments.

• Be consistent -- always carry your food diary or use a diet-track application on your smartphone.

"A food journal doesn't have to be anything fancy," McTiernan said. "Any notebook or pad of paper that is easily carried or an online program that can be accessed any time through a smartphone or tablet should work fine."

Another good weight-loss strategy is to eat at regular intervals without skipping meals.

"The mechanism is not completely clear, but we think that skipping meals or fasting might cause you to respond more favorably to high-calorie foods and therefore take in more calories overall," she said.

The study authors also said eating in restaurants wasn't good for dieting because it "usually means less individual control over ingredients and cooking methods, as well as larger portion sizes."

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