Chapter 12
Your Thyroid Diet Revolution: Making It Happen

The greatest revolution of our generation is the discovery that human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives.

—WILLIAM JAMES

So now you know about the foods, the mind-set, the activity—everything you need to help you start your own Thyroid Diet Revolution. Here are some additional tips, dos and don’ts, and lifestyle guidelines that can help you make your revolution a success.

MEASURE, WEIGH, AND TEST YOURSELF REGULARLY

I frequently hear people advise that you should never get on a scale. And in a perfect world, I’d agree. We should know what to eat and what not to eat, know what’s working for our body. But when you are trying to lose weight and maintain weight loss, many studies show that weighing every day is actually a very valuable feedback tool. In fact, one University of Minnesota study shared that daily weighing helps dieters achieve greater weight loss, and maintain that loss over time.

One study found that dieters who weighed themselves every day lost two times the weight of people who weighed themselves once a week. They say this is because the scale helped the dieters who weighed themselves daily to focus on their weight-loss goal and that tracking weight can actually improve mood by giving you a sense of control.

Rena Wing, PhD, director of the Weight Control and Diabetes Research Center at Brown Medical School, was part of a study that taught successful dieters “self-regulation,” which basically meant that participants weighed themselves daily, and if weight went outside a five-pound range around their target weight, they adjusted diet and exercise to ensure that they returned back to that range. The method worked, and fewer participants regained five or more pounds during the eighteen-month study.

Weigh yourself at the same time every day to get a clearer picture of your true weight—which can fluctuate during the day depending on type of food and drink you’ve consumed, as well as whether you’ve had a bowel movement. It is also important to put the scale in the same place for consistency, since the type of floor can change the reading by a few pounds. Flat surfaces are best because bath mats and carpet can give you an inaccurately low reading. (Wondering if your scale is accurate? A dumbbell can be used to check.)

Hopping on a scale to keep track of weight loss is also important because as you’re losing weight, it provides specific feedback regarding how your body responds to different foods and activity levels. Do you gain several pounds seemingly overnight after you’ve eaten bread or had dairy products? This may be a clue to a sensitivity that is affecting your ability to lose weight. Do you find that you lose a bit more weight after you’ve had a few days of good hydration? This is another clue about how you lose weight that you’ll want to take note of and incorporate into your ongoing program.

Body measurements are also important, especially your waist measurement, because it gives a picture of cardiovascular and diabetes risk and is a marker for insulin and leptin resistance. Particularly for thyroid patients, who may have more early results in building muscle than in losing pounds, keeping track of measurements can provide important feedback and may even provide incentive on those days or weeks when you don’t see much movement on the scale.

Finally, don’t forget to have periodic thyroid blood tests. You will probably be adding fiber to your diet, so your thyroid levels should be retested about six to eight weeks after you stabilize at a new level of fiber intake, because you may need a change in your dosage of thyroid hormone replacement. Remember also that if you lose more than 10 percent of your body weight, that is also a time to get retested, because you may need an adjustment to your dosage.

If your insurance covers retesting, that’s terrific. But if your doctor’s office will not retest as often as you need to while you’re on a weight-loss program, or if the retesting is expensive and you’ll have to pay for it out of pocket, consider ordering your own thyroid tests via a self-testing service such as MyMedLab. Information on self-testing with MyMedLab is in the Resources section.

KEEP TRACK OF WHAT YOU EAT

It’s essential to make healthy eating a habit. This is where tools for planning and tracking, as well as support from other people on the journey, can make or break your efforts. Whatever program you’re following or however you are eating, research shows that writing down what you eat, tracking calories and nutrition, helps make any diet more successful.

The explosion of online tracking programs and apps for smartphones make it very easy to keep track of data related to your diet and fitness, including foods eaten, calories, nutritional composition of your daily and weekly diet, intake of carbs and fat, water intake, minutes or hours of activity, calories burned, hours slept, and other details.

The tool you choose depends on whether you’re participating in a particular diet program. If you’re following the South Beach Diet or Weight Watchers, for example, membership includes access to their Internet-based tools. DukeDiet.com has a personalized meal planner, shopping list tool, nutrition guide, weight tracker, exercise video library, food log and journal, calorie and fitness calculators, and more, for people who access their online program.

There are also a number of free online services that provide a combination of tracking tools and support communities. These include CalorieCount, FitDay, and SparkPeople. SparkPeople, for instance, allows you to develop a personalized diet and fitness plan, and includes calorie counters, workout trackers, recipes, exercise demos and videos, and active communities for dieters, organized around geography, specific diseases, and other unique interests. SparkPeople also has apps for the iPhone, BlackBerry, and other mobile devices that allow you to access it on the go. Other popular mobile trackers include MyFitnessPlan, LoseIt, and dozens more calorie, diet, and fitness tracking apps.

Jojo, a hypothyroid woman in her mid-forties, said that she used an iPhone application—LoseIt—to help with her successful diet:

The app makes it easy to look up calories and to track them. I lost twenty pounds in three and a half months, and I’ve been able to maintain that. What I found was that I learned quite a bit about my eating habits, and by logging what I ate every day, it really made this more of a lifestyle change than a diet. Now, if I want a donut, I get the one with the least calories, and I adjust what I’ve eaten the rest of the day. And it keeps track of calories by the week as well. So, over time, a great day followed by a bad day can balance each other out, so I never end up saying, “I blew my diet—I give up!” I even use the app to plan what I’ll get before I go to a restaurant, so I don’t have to even open the menu and get tempted. I’m too easily distracted by cheese and carbs to trust myself!

One of my favorite tools is an especially powerful software program called DietPower. Company president Terry Dunkle created this diet software in 1998 in response to his own health problems. DietPower software costs around $35 but is available for a free trial to test the program. Central to DietPower is an innovative calorie counter that tracks thirty-three nutrients, monitors your metabolism, and recommends foods you like that are best for your nutrition. It takes about five minutes a day to track your food intake with the program. Personally, in terms of providing detailed nutritional information, I think DietPower is the best of all the tracking tools. You can get information about how to download a free trial of DietPower, and links and information to all the tools mentioned, among others, at the book’s website at ThyroidDietRevolution.com.

EAT SMART WHEN YOU EAT OUT

In general, Americans are eating out more than ever before. And this may be contributing to expanding waistlines.

A large coffee drink can have as many calories as a McDonald’s Big Mac. A blueberry muffin at your favorite coffee spot can have 500 calories. An order of kung pao chicken at your favorite Chinese restaurant can have 1,600 calories. Fettuccine Alfredo will set you back 1,500 calories. And one of those batter-dipped, deep-fried whole onions served with dipping sauce? You’re talking about more than 2,000 calories and 163 grams of fat.

Restaurant food tends to be high-calorie, loaded with simple carbohydrates, and served in huge portions. Some restaurants now have healthier options on the menu, and at most restaurants you can get a salad, dressing on the side, and some grilled chicken, beef, fish, or shrimp. Skip the bread, rice, pasta, and dessert. One technique I like to use is to ask for a takeaway container right from the start. I put half or more of my meal away immediately, which removes the temptation to overeat.

If you have to eat at a burger place, get a burger or chicken sandwich, take off half or all of the bun, get a side salad without dressing, and definitely skip the fries! One 6-ounce order of fast-food fries typically has as much as 600 calories and 30 grams of fat.

FOLLOW THE 95/5 OR 99/1 RULE

When you’re starting out on an effort to lose weight, it’s impossible to be “perfect.” That’s why it’s useful to adopt the 80/20 or 90/10 rule, basically aiming to follow your guidelines 80 or 90 percent of the time. But if you’re not losing weight on a sound diet, or when you have a thyroid problem that is making your metabolism less efficient, you may want to eventually move toward a 95/5 or even 99/1 rule. When you are trying to rehabilitate and repair your metabolism, you really can’t afford much in the way of splurges, treats, cheat days, or multiple “just this once” occasions.

In particular, pay attention to weekends. We have a tendency to want to give ourselves the weekend off from dieting, but consistency is going to be important for you. One study found that most Americans consume more calories, fat, and alcohol Friday through Sunday compared with the rest of the week—sometimes as much as 100 calories more a day. If you do this every Friday, Saturday, and Sunday, those extra weekend calories could slow down or stall your weight-loss efforts. If you’re in maintenance, it could result in weight gain.

GET SUPPORT FROM OTHERS

When it comes to weight loss, some of us are social animals and do better when we’re in a support group. One study looked at more than five hundred people, half of whom were doing a self-help weight-loss program and half of whom were doing a commercial weight-loss program. After two years, about 150 people from each group were still continuing. The self-help group lost about three pounds in a year on average, then gained it back during the second year. In contrast, the commercial group—those going to Weight Watchers—maintained a weight loss of around ten pounds in the first year and after the second year concluded they were still an average of six pounds lighter than when they started. Those who went to more Weight Watchers sessions did better than those who attended fewer sessions.

If you find in-person support and camaraderie essential, consider joining a group like Weight Watchers or Overeaters Anonymous. Local hospitals also frequently offer weight-loss support groups, and many companies even encourage employees to organize weight-loss groups or lunchtime walking programs for weight loss.

If group support is not your style, you may prefer more of a one-on-one counseling approach. You have several options. You can work with a dietitian, nutritionist, or therapist who has a style and philosophy compatible with your own. This may sound expensive, but in the long run it’s comparable to what you’d end up paying for some of the more costly commercial weight-loss centers that offer one-on-one counseling, and you won’t have the pressure to buy products and supplements. Plus you’ll have much more customized support from highly trained experts, rather than a canned diet program and support from folks who typically are not experts in physiology, nutrition, weight loss, or cognitive behavioral therapy, although they are trained to help you implement their company’s program.

Finally, more and more people are turning to online support communities to help with weight loss. There are thousands of interactive forums, bulletin boards, chats, listservs, and other interactive online support activities available twenty-four hours a day. The key is to find the community that has the types of support you need when you need it. You may want to participate in a community at a paid online program such as South Beach Diet or Weight Watchers, join a free weight-loss and diet message group such as those found at CalorieCount or SparkPeople, or participate in the specialized thyroid diet and weight-loss support groups we have at ThyroidDietRevolution.com and on Facebook.

BE WILLING TO TRY SOMETHING NEW

One way to make healthy eating more exciting—and flavorful—is to try new foods. For example, whenever I mention the grain quinoa, eyes start glazing over. (I know, because before I ate it, mine did too.) You probably don’t even know how to pronounce quinoa (it’s “keen-wah”), much less cook it, so it’s not likely that it will end up on your grocery list. But why not? Quinoa, which resembles couscous and has a delicious, slightly nutty flavor, is gluten-free, high in fiber, high in protein, and lower in carbohydrates than most grains, making it a healthy food in general, and one that can be especially helpful for thyroid patients who are trying to eat healthy and lose weight. You can find quinoa in most grocery stores in the rice or pasta aisle, or you can get it in bulk at stores such as Whole Foods.

If you want to start using quinoa, the best thing to do is cook up a batch of it at the start of the week. It’s really easy to cook—trust me! Just rinse the quinoa in a strainer under the tap until water runs clear. Then put it in a saucepan, and whatever amount of quinoa you have, add double the amount of water. Bring to a boil. Reduce the heat to a simmer, cover, and cook until all the water is absorbed, usually ten to fifteen minutes. When quinoa is cooked, it will appear translucent. That’s it. After cooking, you can store your quinoa for up to a week in an airtight container in the refrigerator.

I love quinoa as a breakfast cereal—I add plain yogurt and some fresh berries and mix it all up to make a cold, fruity breakfast “porridge” of sorts. It’s delicious! For an on-the-go lunch, take some cooked quinoa, add chopped tomatoes and onions, goat cheese or feta cheese crumbles, some seeds or nuts, and a vinaigrette dressing, and you have a healthy, filling, high-protein salad. You can even add some chicken, shrimp, or beans for extra-filling protein. Or you can toss in some garlic and parsley and heat to serve it as a side dish. Cooked quinoa is also a great substitute for rice or pasta as a base for chili or stews.

Karilee Shames, PhD, RN, a holistic health expert and therapist who herself has a thyroid problem, is sensitive to dairy products. Says Karilee:

One thing that really works for me, since I had to give up cow’s milk cheeses years ago, is sheep’s milk or goat cheese. I find I can digest it easily. I sometimes make a sandwich with goat cheese, sprouts, whatever greens I have (I love basil and arugula). So it’s like an open-faced sandwich-salad. I sometimes put tomato and avocado on it, then drizzle with olive oil and lemon. It’s like a full salad that is also a sandwich, giving plenty of aminos, minerals, and protein.

Karilee is also a fan of smoothies:

I like to start the day with a shake that really helps get me going in the morning. It’s a breakfast salad! I like to use hazelnut, rice, or a similar nut milk, add my omega oils, then put my salad greens in there and whip it up. The milks have protein, but you can always add your favorite protein powders from health food stores. Most blenders will mix up greens, but I find the Vitamix is the best gift we can give ourselves. You can put anything in there with any liquid and blend it into a drink or soup.

IDENTIFY YOUR TRIGGER FOODS

While there are guidelines, we all have foods that we know we need to particularly avoid, even if they haven’t been identified as common allergens. So think about your own personal “hit list” of trigger foods that you should limit or even avoid. These would include foods and drinks that:

• Cause an allergic reaction

• Give you diarrhea, stomach cramps, or abdominal pain

• Cause you to feel shaky, sweaty, dizzy, or light-headed

• Make your pulse go up

• Make you hungrier than before

• Make you feel tired

• Make you feel bloated

• Make your skin break out

• You can’t control—as in you just can’t eat one, so you eat the whole box, bag, or carton

A weight-loss journal, food diary, or tracking system, along with daily weigh-ins (if you can stand it), can really be a help. After a few weeks of tracking, you’ll start to see patterns that reveal some of the unique aspects of your own physiology and way of eating, and how you respond to particular foods.

I can’t tell you which foods will be on your personal list, because that list will be unique. Some people can drink a cup or two of coffee; other people find that it makes them shaky and messes up their blood sugar for the day. Some people can use dairy products, whereas others find that dairy gives them a stomachache, bloats them up for a day or two, and stalls weight loss. In my own case, here are a few examples:

• I’m very allergic to raw tree fruits (apples, pears, peaches, plums, cherries) and tree nuts (walnuts, pecans, etc.).

• I cannot eat just one Butterfinger, so I don’t eat any.

• Drinking fruit juice (like orange juice) makes me shaky and incredibly hungry.

• I seem to have some intolerance to milk products, so I avoid drinking milk—but I can eat yogurt.

So it’s going to be up to you to determine which foods maximize your metabolism, help you to feel your best, and help you to lose weight most effectively while not feeling hungry, bloated, constipated, and so on.

AVOID HIDDEN PERSUADERS

There are many “hidden persuaders” built into our economy and society—these are factors, products, and situations that subtly encourage you to eat more than you realize. These include:

•  Extra-large and “supersize” containers. Studies show that you are very likely to eat more from a larger container than a smaller one.

•  All-you-can-eat buffets, “unlimited pasta bowls,” etc. People rarely will limit their intake to a healthy amount when they are in a situation with unlimited food.

•  Store sales. Studies show that people tend to buy more of a food item if the sign says it’s “3 for $6” than if it says “$2 each.”

Do your best to avoid all-you-can-eat and buffet-type restaurants, and when they ask you if you want to supersize, well, you know the answer!

GET ENOUGH SLEEP

If you want to lose weight, you are going to have to get enough sleep. According to the National Sleep Foundation, most adults need from seven to nine hours a night, yet the average American gets only six and a half hours of sleep per night, and two out of every ten Americans sleep less than six hours a night.

What happens if you don’t get enough sleep? Insufficient sleep may:

• Reduce basal metabolic rate

• Cause more cortisol to be released, increasing stress and hunger

• Reduce non-exercise-associated thermogenesis—the involuntary activity, such as fidgeting, that burns excess calories during the day

• Interfere with the body’s ability to metabolize carbohydrates, causing high blood levels of glucose, which leads to higher insulin levels and greater fat storage

• Drive down leptin levels, which causes the body to crave carbohydrates

• Reduce levels of growth hormone, which helps regulate the body’s proportions of fat and muscle

• Lead to insulin resistance and contribute to increased risk of diabetes

• Increase blood pressure

• Increase the risk of heart disease

A study of nearly seventy thousand women found that those who sleep five hours or less per night are 32 percent more likely to experience major weight gain—defined as an increase of thirty-three pounds or more—over a sixteen-year period and 15 percent more likely to become obese, compared to those who slept seven hours a night. Even six hours wasn’t quite enough—the women who slept six hours per night were still 12 percent more likely to have major weight gain and 6 percent more likely to become obese, compared to the women getting seven hours of sleep per night. (Note that they tried to see if sleep was connected to activity level, but there was no correlation between exercise levels or physical activity and sleep. What they did find is that the women who were getting less sleep were actually eating less, yet gaining more weight.)

Even in young, healthy people, a sleep deficit of three to four hours a night over the course of a week has a triple-whammy effect on metabolism. Just this limited amount of sleep deficit interfered with the ability to process carbohydrates, manage stress, and maintain a proper balance of hormones. In one sleep-restricted week, study participants had a significant loss in their ability to process glucose and an accompanying rise in insulin. Insulin levels were so high, in fact, that the men were considered to be in a prediabetic state.

How much sleep do you need? Target seven hours or more a night of actual sleep. You might try adding an additional fifteen minutes per night each week, until you get to a point where you are waking refreshed and are not exhausted during the day. You’ll also want to make sure that the sleep you’re getting is of good quality. That means no light in your bedroom—turn off the television, the lights, and your cell phone, and use room-darkening curtains or shades, because ambient light can disturb sleep and interfere with the normal nightly melatonin and growth hormone cycles. Avoid disturbing television or books in the hour or two before bedtime. Don’t bring work, bills, studies, or your telephone to bed; avoid caffeinated products after midafternoon; and consider taking a warm bath or shower before bedtime.

A Few More Tips

• Regular exercise can help, but try to avoid exercise within three hours of bedtime because it can jazz you up too much.

• Avoid caffeine, nicotine, and alcohol in the late afternoon and evening.

• If you have trouble sleeping at night, don’t nap during the day.

• If you can’t sleep, don’t stay in bed. After thirty minutes, go to another room and do something else that is relaxing until you feel sleepy.

• Try melatonin. For some people, 1 to 3 mg at night, an hour before bedtime, can help them fall asleep and have more restorative sleep.

GET MOVING

Don’t forget that you have to move. Weight-bearing exercise is critical to raising metabolism. I’m not suggesting that you have to live in the gym or take up step aerobics, but you’ll need to move. Gentle exercise helps lower insulin resistance, increase growth hormone, and build muscle, without increasing appetite.

Some diets and weight-loss programs tell you that you can lose weight without any exercise. That may be true for some people and some programs. But it’s not likely to be true for most thyroid patients. And what those diet programs don’t tell you is that most people who are not exercising will eventually regain the weight over time. Even if you’re not a big fan of physical activity, you’ll have to accept it: moving your body is not optional. I talk about this more in chapter 9.

CONSIDER A SPECIAL DETOX, CLEANSE, OR JUMP START

Some dieters find that starting off a new way of eating with a detoxification program, a cleanse, or even a short fast can ease your shift into healthier eating and help jump-start the weight-loss process.

Therese, a thyroid patient, said that she always loses weight and feels great when she visits a vegan health spa.

Daily exercise, vegan food (including raw food and sprouts), wheatgrass juice two times daily, walks outside daily, a sauna two to three times a week, three meals a day and nothing in between except for herb teas and water. After ten days I feel totally energized and have lost weight (usually seven to nine pounds), and symptoms like joint pain and stiffness vanish.

Two-Week Jump Start: Smoothie Shakedown

As I mentioned earlier, I especially like Dr. Ann Louise Gittleman’s Fat Flush Body Protein, a protein powder for smoothies. I also like her Fat Flush Kit, a combination of three separate supplements—a multivitamin, gamma-linolenic acid, and a weight-loss formula that includes chromium and acetyl-L-carnitine. The Fat Flush Body Protein and supplements are combined in a two-week jump-start program created by Dr. Gittleman called the Smoothie Shakedown. If you are looking for a gently detoxifying way to jump-start your own weight loss, I think the Smoothie Shakedown can be a good choice for thyroid patients.

Basically, it involves having a Fat Flush Smoothie for breakfast and lunch. The smoothie is made with the Body Protein, plus some low-glycemic fruit, a small spoonful of flaxseed oil, some ground flaxseed or chia seeds, and water. Then dinner is 4 to 6 ounces of grilled or broiled lean protein, unlimited veggies, a large salad, and a dressing of either lemon juice or apple cider vinegar.

In addition, Dr. Gittleman recommends drinking half your body weight (in pounds) in ounces of water (so if you weigh 150 pounds, you’d drink 75 ounces of water), and using the Fat Flush Kit supplements if possible.

While I frequently use the Fat Flush Body Protein to make breakfast smoothies, I’ve also followed the Smoothie Shakedown program, and when I’m on it for those two weeks, I feel energetic and usually lose at least four or five pounds. Some thyroid patients have reported losing as much as ten pounds.

Websites: www.unikeyhealth.com/shakedown, www.annlouiseforum.com/fat-flush-smoothie-shakedown, www.smoothieshakedown.com

GO TO “WEIGHT LOSS PLEASURE CAMP”

As you may have noticed, I have frequently quoted nutritional psychologist Marc David, author of The Slow Down Diet: Eating for Pleasure, Energy, and Weight Loss, and weight-loss expert Jena la Flamme, founder of New York City’s popular Jena Wellness Center. David is the founder and director of the Institute for the Psychology of Eating and a pioneer in the psychology of eating. Both are graduates of the prestigious Institute of Integrative Nutrition in New York.

Marc and Jena are knowledgeable nutritionists who have a very mind-body approach to weight loss, and they have joined forces to create an online workshop called Weight Loss Pleasure Camp.

Weight Loss Pleasure Camp is not a diet, but rather a way of applying the key principles outlined in The Slow Down Diet and in Jena’s successful weight loss and wellness coaching. The premise of their approach is that when you experience the pleasure of food, you are able to maximize metabolism and fat-burning power.

In The Slow Down Diet Marc David says:

We can only achieve and sustain optimum metabolism when we eat, exercise, and live under an optimum emotional state. Our frame of mind directly impacts metabolism to such a degree that what we think and feel profoundly influences how we digest a meal. Metabolic power is not only about what you eat but who you are when you’re eating.

The Weight Loss Pleasure Camp program helps you learn how to eat, exercise, and live under an optimum emotional state, and how to harness the power of mind, emotions, and hormones to aid in metabolism.

Their four-week telecoaching program focuses on providing step-by-step training in their unique weight-loss principles, tools, ideas and strategies, which focus not on dieting, deprivation, food restriction, portion control, self-control, calorie reduction, diet pills, and exercise, but instead on relaxation, pleasure, sensuality, curiosity, nourishment, and nurturance as foundations for weight loss.

Sessions focus on how to use pleasure as a catalyst for lasting weight loss, shifting away from deprivation-based dieting methods, how men and women lose weight differently, how to base a weight-loss approach on pleasure-based strategies, how to join forces with body wisdom, using intimacy with your body to fuel fat burning, techniques for achieving emotional satisfaction with food, and ways to sustain weight loss and stay on track.

I highly recommend Weight Loss Pleasure Camp as a unique and effective way to start off any new way of eating.

Website: www.weightlosspleasurecamp.com