You can keep a food and symptom diary on paper, using a printable form or your own notebook. The Alberta Health Services food, lifestyle and symptom diary is a printable two-page form you can use as a model. This page covers what to write, what studies say about symptom diaries and when to see a doctor instead.
Is a food and symptom diary free?
The Alberta Health Services handout is a printable two-page form. According to the handout, it was developed by Registered Dietitians in Nutrition Services. Its text says it may be reproduced without permission for non-profit education purposes, and it may not be changed without written permission from NutritionResources@albertahealthservices.ca. The Alberta handout does not show whether personal use is covered, so send that address a question if you need to know. The form is dated April 2017.
Apps and paid downloads vary. Check the price and terms on the app store listing or download page before you install or pay. Prices and download terms can change, so check the Alberta Health Services website for the current form before you print.
What is a symptom diary?
A symptom diary is a written record, kept day by day, of symptoms and the things that may be linked to them. Food is one of those things. Harvard Health’s daily tip on food diaries says keeping a food diary can help you identify foods that don’t agree with you. It suggests listing the foods you eat and any symptoms that occur, every day (Harvard Health food diary tip).
How do I keep a food and symptom diary?
The Alberta handout has five parts. Write in it every day.
- Food and drink. Write down everything you eat and drink, with the time. Include how it was prepared (fried, baked, boiled or barbecued), anything added during or after cooking, and details of restaurant, fast or packaged foods. Snacks, sweets, chewing gum, mints and candies count too.
- Portions. Estimate with the table below, or use measuring cups and spoons if you can.
- Medicines and supplements. Record the dose and the time for any medicine, supplement or natural health product.
- Bowel symptoms. Record when symptoms happen and each bowel movement, with its consistency and amount. The handout’s example reads “7:00 a.m. – diarrhea, large amount.”
- Other factors. Note stress level, emotions, sleep quality, activity and hormonal changes such as menses or menopause.
How much is a portion?
The Alberta handout gives these comparisons to help you estimate amounts.
| Amount | What it looks like, per the handout |
|---|---|
| 2 ½ oz (75 g) of meat | The palm of your hand |
| 1 ½ oz (50 g) of cheese | Your thumb |
| 1 cup (250 mL) | Your fist |
| ½ cup (125 mL) | A hockey puck |
| 2 Tbsp (30 mL) | 1 golf ball |
| ¼ cup (60 mL) | 2 golf balls |
| 1 tsp (5 mL) | A thumb tip |
What does the research say about keeping a symptom diary?
Symptom diaries are mostly studied as measurement tools, and the studies below look at conditions other than food reactions.
- A 2025 study of a pediatric functional constipation symptom diary, using data from 328 children aged 6 to 17, found that scores on stool frequency and stool consistency were consistent across repeated use (intraclass correlation of 0.91 and 0.56). The authors also set a meaningful change threshold of two or more bowel movements a week (pediatric constipation symptom diary study).
- A 2015 study of an asthma symptom diary found that paper and electronic versions gave equivalent results. The paper-and-pencil and electronic modes were equivalent for symptom-free days (intraclass correlation of 0.84) (asthma symptom diary study).
- A 2017 secondary analysis of a randomized trial of 393 rural patients with heart failure found that greater diary use was associated with longer survival. High and very high diary users were less likely to die from any cause (heart failure diary study).
These studies don’t test whether a food diary identifies which foods affect you. That is the question to take to your clinician or a dietitian. What they show is that some symptom diaries have performed acceptably as measurement tools in clinical trials, with varying reliability, and that many trial participants completed them over months. They do not show that a food diary works.
Should I use a notebook, a printed form or an app?
The Alberta form is a printable two-page sheet. One study of an asthma symptom diary found paper and electronic versions gave equivalent results. That study did not test food diaries. Pick the one you will keep up every day and the one you are comfortable keeping private. Before you install an app, read its price and privacy terms.
When should I see a doctor instead of keeping a diary?
A diary does not replace care. If your symptoms could be food poisoning, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) lists signs that mean you should see a doctor right away. For adults, these include:
- A change in mental state, such as irritability, lack of energy or confusion
- A high fever
- Vomiting often
- Six or more loose stools in a single day
- Diarrhea that continues for more than 3 days
- Nervous system symptoms, severe pain in the abdomen or rectum
- Stools that are black and tarry or contain blood or pus
- Symptoms of dehydration or other complications
The full list, including guidance for infants and children, is on the NIDDK food poisoning symptoms page.
What should I do next?
- Print the Alberta form, or start a notebook with the five parts above.
- Log every meal, snack and drink, with portions and preparation. Ask your clinician or dietitian how long to keep the diary.
- Add medicines, supplements, bowel symptoms and sleep, stress and activity notes.
- Bring the diary, with dates and times, to your next appointment.
If bloating or other gut symptoms keep coming back, our guide to leaky gut symptoms covers what these symptoms can mean and what else causes them. If your symptoms look more like a cold or flu, our flu season symptoms guide covers cold, COVID and RSV questions.
Questions to ask your clinician
- Which entries in my diary should we look at first?
- Would a referral to a dietitian help me read this diary?
- Which of my medicines and supplements should I list, and should any be reviewed?
- Which symptoms need an in-person check now, rather than later?
- If we try a food change, how should we track the result?
By Gut, Gum and Nail Health Editorial Team