Tracking Triggers: Keeping a Food Diary

For people with Crohn’s disease, the fear that food will worsen a symptom or induce another flare-up often prevents them from eating a balanced and healthy diet. A food diary (or food journal) can help you track those food triggers. It doesn’t have to be complicated or extravagant. A simple notebook or spreadsheet will work. The goal of a food diary is to help you and your healthcare providers identify foods and drinks that may make symptoms worse and cause diarrhea, stomach cramping, bloating.

Important Steps for a Food Diary

“The foods that trigger symptoms differ person to person,” says Jeannie Gazzaniga-Moloo, a registered dietitian and spokesperson for the American Dietetic Association. “One of the most important reasons to keep a food diary is to identify a diet plan that’s best for you. The diary helps us tailor a plan to meet your needs.”

• Record what you eat and drink, plus the serving size, each day. It’s OK if you don’t know the exact portion size or measurement; you can use descriptive comparisons such as “chicken breast the size of a deck of cards.” What’s important is that you record everything you consume.
• Make a note of any symptoms you feel after eating the food. Without knowing your reaction to foods, it’s hard to identify triggers.
• Keep the diary for a minimum of three weeks—or at least through a complete cycle with an inactive period and a flare-up.
• Remember to list any multivitamins or supplements you’re taking. People with Crohn’s disease are often at a higher risk for malnutrition or symptoms related to insufficient nutrition due to malabsorption. Knowing your total nutrient intake from foods and supplements will help ensure you’re getting the recommended daily amounts for vitamins and nutrients.

Adjust Your Diet and Experiment

Once you have enough information, make an appointment to discuss your food diary with your physician or a registered dietitian. After the two of you have identified possible triggers, you can remove these foods from your diet or modify your intake of potential triggers.

Once you have adjusted your diet by removing or reducing the intake of potential triggers, keep your food diary for another cycle, and discuss the new data with your doctor. You may find that you had fewer problems during the new cycle and the foods you identified were causing digestive issues. You may also discover new food triggers and may need to make further adjustments—cutting back on potential triggers and increasing “safe” foods to make up for lost vitamins and nutrients.

Maintaining proper levels of nutrition and hydration during inactive periods of the disease will help your body heal and prepare for the next episode of flare-ups. Your doctor or dietitian may use the information from your food diary to ensure you’re fueling your body properly and getting enough nutrients to sustain you through the disease’s ups and downs.