Kaiser Permanente issued the following news release about a study
conducted at Duke University Medical Center, Pennington Biomedical
Research Center, Johns Hopkins University, and Kaiser:

Study finds keeping a food diary doubles diet weight loss

Study is 1 of few trials to recruit large percentage of African American

July 8, 2008 (Portland, Ore.) – Keeping a food diary can double a
person’s weight loss according to a study from Kaiser Permanente’s
Center for Health Research. The findings, from one of the largest and
longest running weight loss maintenance trials ever conducted, will be
published in the August issue of the American Journal of Preventive Medicine.

Funded by the National Heart, Lung and Blood Institute at the National
Institutes of Health, the study is one of the few studies to recruit a
large percentage of African Americans as study participants (44
percent). African Americans have a higher risk of conditions that are
aggravated by being overweight, including diabetes and heart disease. In
this study, the majority of African American participants lost at least
nine pounds of weight, which is higher than in previous studies.

“The more food records people kept, the more weight they lost,” said
lead author Jack Hollis Ph.D., a researcher at Kaiser Permanente’s
Center for Health Research in Portland, Ore. “Those who kept daily food
records lost twice as much weight as those who kept no records. It seems
that the simple act of writing down what you eat encourages people to
consume fewer calories.”

In addition to keeping food diaries and turning them in at weekly
support group meetings, participants were asked to follow a heart-
healthy DASH (a Dietary Approaches to Stop Hypertension) diet rich in
fruits and vegetables and low-fat or non-fat dairy, attend weekly group
sessions and exercise at moderate intensity levels for at least 30
minutes a day. After six months, the average weight loss among the
nearly 1,700 participants was approximately 13 pounds. More than two-
thirds of the participants (69 percent) lost at least nine pounds,
enough to reduce their health risks and qualify for the second phase of
the study, which lasted 30 months and tested strategies for maintaining
the weight loss.

“More than two-thirds of Americans are overweight or obese. If we all
lost just nine pounds, like the majority of people in this study did,
our nation would see vast decreases in hypertension, high cholesterol,
diabetes, heart disease and stroke,” said study co-author Victor
Stevens, Ph.D., a Kaiser Permanente researcher. For example, in an
earlier study Stevens found that losing as little as five pounds can
reduce the risk of developing high blood pressure by 20 percent.

The Kaiser Permanente Care Management Institute’s Weight Management
Initiative (http://www.kpcmi.org/weight-management/index.html) has
recommended food journaling as a strategy for losing weight since 2002.
The Weight Management Initiative unites clinicians, researchers,
insurers, and policymakers to identify practical, effective, non-
surgical approaches for the prevention and treatment of overweight and

“Keeping a food diary doesn’t have to be a formal thing. Just the act of
scribbling down what you eat on a Post-It note, sending yourself e-mails
tallying each meal, or sending yourself a text message will suffice.
It’s the process of reflecting on what you eat that helps us become
aware of our habits, and hopefully change our behavior,” says Keith
Bachman, MD, a Weight Management Initiative member. “Every day I hear
patients say they can’t lose weight. This study shows that most people
can lose weight if they have the right tools and support. And food
journaling in conjunction with a weight management program or class is
the ideal combination of tools and support.”

The study, coordinated by the Kaiser Permanente Center for Health
Research in Portland, also was conducted at Duke University Medical
Center, Pennington Biomedical Research Center, and Johns Hopkins
University. In addition to Hollis and Stevens, the Kaiser Permanente
research team included William M. Vollmer, Ph.D.; Cristina M. Gullion,
Ph.D.; Kristine Funk, M.S.; and Daniel Laferriere, MR. Other study co-
authors included Phillip J. Brantley, Ph.D. and Catherine M. Champagne,
Ph.D. at Pennington; Jamy D. Ard, MD, at the University of Alabama at
Birmingham; Thomas P. Erlinger, MD, MPH, at the University of Texas;
Lawrence J. Appel, M.D., and Arlene Dalcin at Johns Hopkins; Pao-Hwa
Lin, Ph.D., and Laura P. Svetkey, MD, at Duke University; Carmen Samuel-
Hodge, Ph.D. from the University of North Carolina at Chapel Hill; and
Catherine M. Loria, Ph.D., at the National Heart, Lung, and Blood
Institute and National Institutes of Health.