Review
Self-Monitoring Dietary Intake: Current and Future Practices

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This article reviews the literature on the use of paper diaries for self-monitoring food intake, identifies the strengths and limitations of paper-and-pencil diaries and their new counterpart, the electronic diary or personal digital assistant (PDA), and reports how participants were trained to use a PDA with dietary software in two pilot studies—one with hemodialysis patients and the other with participants in a weight loss study. The report of the pilot studies focuses on the practical issues encountered in training participants in the use of a PDA and addresses the pros and cons of different dietary software programs. Six hemodialysis patients were trained in the first study and seven participants attempting to lose or maintain their weight were trained in the second pilot study. The training focused on how to use a PDA and how to navigate the dietary software to self-monitor food intake. The goals of using the PDA were to improve adherence to the therapeutic diets and to self-monitoring. Lessons learned from the pilot studies are shared.

Section snippets

Use of Self-Monitoring in Making Dietary and Eating Behavior Changes

Self-monitoring food intake is considered the cornerstone of behavioral treatment of obesity and other chronic disorders that can be managed by dietary modification and control, such as ESRD, diabetes, and dyslipidemia.11, 13, 16 Self-monitoring is conducted as a systematic observation and recording for the purpose of increasing the individual’s awareness of eating behaviors and food consumed. The individual is instructed to record all food intake (energy consumption or target nutrients) and,

Report of Experience Training Individuals in the Use of a PDA in Two Pilot Studies

One of the goals of the pilot studies was to examine the feasibility of teaching hemodialysis (HD) patients and individuals in a weight loss study to use PDA devices for self-monitoring. The full report of the HD pilot study, the accompanying behavior intervention, and clinical outcomes are reported in a companion article in this issue.28 This article focuses on the PDA training in these two pilot studies. The protocols for the studies were approved by the University of Pittsburgh Institutional

Discussion

As a tool to self-monitor dietary intake, BalanceLog and Diet Mate Pro provide some real advantages over the use of paper diaries and the traditional methods of dietary counseling with HD patients or individuals prescribed a therapeutic diet. In managing patients with ESRD treated with HD, renal dieticians typically examine dry weight and serum albumin levels to assess whether or not their patient is consuming sufficient calories and protein. They also review serum laboratory data to assess

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    Support was provided by NIH, NIDDK, RO1-DK58631; support for the hemodialysis pilot study was received from the Obesity and Nutrition Research Center NIH-NIDDK No. DK-046204; the General Clinical Research Center NIH-NCRR-GCRC No. 5M01-RR00056; and the Center for Research in Chronic Disorders, NIH-NINR No. P30-NR03924.

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