How to track your diet with IBD

If you have Crohn's disease or ulcerative colitis, you’ve probably considered or been told to track your diet to identify your trigger foods or to make sure you’re getting the nutrients your body needs on a daily basis.

In this post, we share some expert tips on how to track your diet and when it might not be worth it.

When should you track your diet?

There are many reasons you may consider tracking your diet when you have IBD:

• You want to know which foods trigger your symptoms and know what you’re looking for - Do you have an increase in symptoms after eating certain foods, such as fried foods? When you know what could be triggering symptoms, it’ll be easier to find your trigger foods.  
• You want to know if you’re getting enough nutrients - are you eating enough throughout the day? Are you eating a variety of foods or the same few foods every day?  Are your meals keeping you full for a few hours or are you hungry throughout the day?
• You want to know how your eating habits change over time - do you eat differently during stressful times?  
• You want to know if you’re skipping or delaying meals - do you skip meals during the day as an attempt to avoid symptoms? Are you listening to your hunger cues or feeling deprived of foods you love? Do you have feelings of loss of control around eating

When should you not track your diet?

There are several situations where we wouldn’t recommend tracking your diet. These include:

• When you’re not sure what you’re looking for - if you don’t know what you’re looking for, tracking your diet may not be helpful - instead, find an IBD dietitian who knows what to look for to help you.
• When you have a history of an eating disorder - if you’ve ever been diagnosed with an eating disorder, we recommend against tracking your diet. This could be triggering of eating disorder thoughts and behaviors.
• When your relationship with food isn’t in a good place - tracking your diet may bring up feelings of guilt or shame around eating certain foods. If you’re already experiencing any of these feelings, tracking your diet could lead to disordered eating behaviors, malnutrition, and worse disease outcomes. 
• When you’re already spending too much time and consideration on food - if you already feel preoccupied with food, tracking your diet may increase the preoccupation and lead to excessive diet restrictions. 

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What to track

If you’re going to track your diet, you’ll want to keep an eye on the trigger foods, pro-inflammatory foods, and anti-inflammatory foods that you consume throughout the day, as well as your hunger cues, cravings, and symptoms.

You may also want to tune into whether you were stressed, busy, or anxious that day and monitor your hydration status.

Other factors that can contribute to symptoms include food behaviors such as skipping meals, overeating, eating while doing other tasks, eating meals quickly, etc.  

Hydration

• Are you drinking enough fluids?
• Are you having carbonated beverages or drinking fluids out of a straw?

Meal patterns

• Are you eating regularly every few hours or skipping meals?

Meal volume

• Are you having snacks or meals throughout the day? 
• Are you skipping meals then having large meals? 

Hunger/fullness

• Are you listening to your hunger cues? 
• Are you listening to your fullness cues?

Nutrient quality 

• Are you getting enough calories and protein throughout the day?
• Are you consuming any good sources of vitamin C or calcium? 

Trigger foods and beverages

• Trigger foods are foods that cause unpleasant symptoms, such as diarrhea, frequent trips to the bathroom, constipation, bloating, pain, acid reflux, indigestion, belching, gas, or cramping.
• Trigger foods are different for everyone which is why everyone with IBD will require an individualized diet
• If you don’t have symptoms after eating common trigger foods - you don’t need to avoid them unless your doctor has told you otherwise. 

Pro-inflammatory foods

• Eating certain foods frequently over time have been found to increase the risk for active disease, and/or increase the presence of bad gut bacteria
• These foods may or may not trigger your symptoms so you can’t rely on symptoms to identify these foods.

Anti-inflammatory foods

• Eating certain foods frequently over time have been found to decrease the risk for active disease and/or increase the presence of good gut bacteria.
• These foods may or may not trigger a symptomatic reaction. 

Satisfaction in eating

• If you’re losing weight, are you also eating a bland diet? That can make it more challenging to eat enough to maintain your weight. 
• Are you including any enjoyable foods in your diet? 

The positives

• We often are most critical of ourselves, so look for things that you’re doing well, as well as areas that you could improve. 

How to track your diet

There are 3 main ways to track your diet. We generally recommend our clients track their diets for 3-7 days (with 3 days being sufficient for most people) to collect enough data to find common trigger and pro-inflammatory foods in the diet.

The app method

There are certain phone apps that allow you to track your symptoms and diet. Some apps also have the ability to track other important factors like when your symptoms began, your stress levels, exercise, hydration status, and sleep quality. Track your diet in an app for 3-7 days. 

The picture method

This is our preferred method for most of our clients because it's easy and gives us a really good picture of what your diet looks like overall. Take pictures of what you eat and drink for 3-7 days. During that time, keep a running note in your phone about the symptoms you experienced and the time of day it occurred. Using these photos and your symptom log, you or your dietitian will be able to look back and review what you ate and what symptoms occurred throughout the week. 

The paper method

Write down everything you eat and drink for 3-7 days on a piece of paper or in the notes app on your phone. Make sure to include the time you ate it, what you ate, and the symptoms you experienced afterwards. 

Considerations when tracking your diet

If you’re thinking about tracking your diet, there are a few things you should consider:

• Many factors can contribute to symptoms in individuals with crohn’s or colitis including stress, sleep, diet, and disease activity. Remind yourself that diet is just one of those factors.
• If you notice you’re becoming preoccupied with your diet, or have increased feelings of guilt or shame after eating certain foods, stop tracking your diet and reach out to an IBD dietitian with eating disorder awareness.
• Be kind to yourself. It’s okay to consume pro-inflammatory foods here and there. If eating a pro-inflammatory food one time leads to a flare, talk to your doctor as you may need to adjust your medication. 
• Keep in mind that your food-related quality of life is important too! It’s okay to eat a meal that triggers your symptoms if you’ll genuinely enjoy it. Sometimes the symptoms are worth it. If you have stricturing Crohn’s, talk to your IBD team to know what is safe for you to consume.
• Try to keep foods you enjoy (including cultural foods) in your diet whenever possible. If a particular food or ingredient in a dish you love triggers symptoms, try reducing the quantity of that food or swap it out for a better tolerated alternative that preserves the quality of the dish. 
• If you can’t figure out your trigger foods or just want more guidance on finding a diet that works for you, consider working with an IBD focused dietitian. 

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Get support tracking your diet and finding your trigger foods

If you’ve struggled to find your trigger foods or you’re eating a restricted diet, request an appointment with an IBD dietitian today.

Our IBD dietitians are specialists in helping people with IBD reduce their symptoms and expand their diet to include the foods they love. We’d love to help you do the same.

Reach out to get started working with a Romanwell IBD dietitian today.