There are a number of important guidelines that can really make or break your success in following The Thyroid Diet.
DRINK ENOUGH WATER
Even if you’re eating exactly the right things and working out, if you’re not getting enough water you may find it difficult, if not outright impossible, to lose weight. This is because the liver, which converts stored fat into energy, acts as a backup to the kidneys in detoxifying the body. If the kidneys are not functioning optimally because they are deprived of water, then the liver is diverted away from fat conversion and toward detoxification.
Ideas about how much water you should drink depend on who you ask, but it’s agreed that a minimum amount is eight 8-ounce glasses a day. Some experts say that you should drink an additional 8-ounce glass for every 25 pounds of weight you need to lose. So, if you are 50 pounds overweight, you should drink two more 8-ounce glasses of water, for a total of ten 8-ounce glasses. If it’s particularly hot out or if you are exercising intensely, the American College of Sports Medicine suggests drinking even more—adding 6 ounces for every 15 minutes of activity. Philip Goglia, author of Turn Up the Heat: Unlock the Fat-Burning Power of Your Metabolism, recommends drinking 1 ounce of water per pound of scale weight. For most of us, this is substantially more than eight glasses. If you are a 160-pound woman, for example, that’s 160 ounces a day, which is equal to twenty 8-ounce glasses a day, or the equivalent of almost three 2-liter-size bottles. And if you are a 200-pound man, that’s twenty-five 8-ounce glasses a day.
I know that the first few days after increasing water intake, you feel as if you’re living in the rest room. But this will calm down. As your body begins to recognize that you are finally taking in enough water, it gives up the water it’s been holding on to. This is also the counterintuitive but true theory that if you want to stop feeling bloated and retaining water, you need to drink more water! You’ll know you’re getting enough when your urine is pale yellow and nearly colorless. If it’s darker, increase your water intake. (Keep in mind, however, that certain vitamins darken your urine, even if you’re getting enough water.)
Spread out water consumption during the day as much as possible. One rule that some experts recommend is that you not drink water while you are eating. The theory is that if you are drinking water with your meal, you may be using it to help swallow food without fully chewing your food. You may want to drink a glass of water before your meal. It’s even better if you can have a big glass of water with some sort of fiber (e.g., psyllium, or Benefiber, or another fiber supplement) before you eat.
There is anecdotal evidence that the stomach absorbs cold water more quickly and that cold water may enhance fat burning. The idea is that your body has to use extra energy to heat the cold water up close to body temperature—98.6 degrees—so this may help you burn more calories. However, there is also some thinking that cold water stimulates appetite and that warmer water is far easier to drink in large quantities. Since there is no real agreement, the best temperature is the one you like best and find easiest to drink. Personally, I have found that I can drink far more room-temperature water and am quite used to it this way. I buy 32-ounce bottled waters with sports caps and walk around all day with one of these.
GET ENOUGH FIBER IN YOUR DIET
Fiber is essential to digestion and will optimize your weight-loss efforts. Sometimes called roughage, it is the part of plant foods that is not digestible. Fiber comes in two forms: (1) soluble, which dissolves in water, and (2) insoluble, which does not. Foods that are high in soluble fiber include oats, barley, peas, beans, and citrus fruits. Soluble fiber is also found in psyllium seed and oat bran. Good sources of insoluble fiber include wheat bran and certain vegetables.
There is evidence that fiber helps with weight loss. Fiber has minimal calories but can fill you up by adding bulk. When consumed with carbohydrates, it helps modulate the insulin response and normalize blood sugar. There is a fair amount of scientific support for fiber’s ability to increase the feeling of fullness after you eat and reduce hunger levels. One study found that adding 14 grams of fiber per day was associated with a 10% decrease in calorie intake and a weight loss of 5 pounds over 4 months.
In another study of 53 women who were moderately overweight and followed a 1,200-calorie-a-day diet over 24 weeks, half were given a fiber supplement and half received a placebo. They were given 6 grams of fiber a day to start, then 4 grams. After treatment, the fiber group lost a mean amount of 17.6 pounds versus 12.76 pounds in the placebo group.
There are some simple ways to incorporate fiber into your diet. Eat raw fruits and vegetables; they have more fiber than cooked or canned. Dried fruits (especially dried figs) are also good sources of fiber. (Note, however, that dried fruits can be high-glycemic, so use them with caution.)
Scan food labels for bread and cereal products listing whole grain or whole wheat as the first ingredient. Two slices of high-bran health bread for example, has 7 grams of fiber, compared to only 2 grams of fiber for white bread.
For breakfast cereal, one of the best is All-Bran. One-half cup has 90 calories and 10.4 grams of fiber. It’s not the tastiest cereal, but it’s really good for you. Doctor it up with a healthy serving of fruit, which adds even more fiber. Or add the cereal, some fruit, and a handful of slivered almonds to plain yogurt, and you have a very healthy snack.
Many nuts are high in fiber and are a source of good fats that help lower cholesterol. Almonds are one of the best nuts for you. One-quarter cup provides 2.4 grams of fiber. I love to sprinkle a few over a serving of 2% cottage cheese with some fruit as a snack.
Beans are a powerhouse. One cup of black beans, for example, provides a whopping 19.4 grams of fiber, with only 190 calories. One-half cup of white beans (cannellini) has 16 grams of fiber and only 160 calories. You can also increase fiber in meat dishes by adding pinto beans, kidney beans, or black-eyed peas.
Other high-fiber foods include apples, oranges, broccoli, cauliflower, berries, pears, brussels sprouts, lettuce, prunes, carrots, and potatoes.
Men younger than 50 require 38 grams of fiber a day, and women need 25 grams. Men over 50 should get at least 30 grams and women at least 21 grams. The typical American diet, however, includes 10 grams of fiber a day or less. You’ll probably have to add a fiber supplement, in addition to emphasizing fiber-rich foods. Start slow because you need to give your intestinal system time to adjust. Adding too much fiber too quickly can cause discomfort.
Some fiber supplements to consider include
One of my favorite fiber products is Dr. Levine’s Ultimate Weight Loss Formula. Developed by internist Scott Levine as a weight-loss aid for his patients, the powdered formula makes a drink that contains five types of healthful fiber. It tastes fairly good. (I’ve tried both the chocolate and raspberry flavors, and they’re fine, especially compared to trying to choke down a couple of spoonfuls of psyllium husks floating around in a glass of water!) Dr. Levine’s formula provides 17 grams of fiber in one serving, so if you have a serving before both lunch and dinner, as he suggests, you will be getting 35 grams of fiber a day as your baseline. According to Levine, many people who use his product lose 1.5 to 3 pounds per week without doing anything else differently—a result achieved because of reduction of food intake, combined with reduced insulin resistance and blood sugar levels, due to the increased fiber in the diet. Because Levine’s formula includes both soluble and insoluble fibers, it has other benefits including reduction of cholesterol. Levine says, “The right kinds of fiber can be particularly helpful for insulin metabolism, especially in people who have even a few extra pounds around the middle. That abdominal weight gain—which drives increasing insulin levels, and is the start of the whole metabolic syndrome—can be helped by high-fiber consumption.”
Important warning: If you switch from a low-fiber to a high-fiber diet, be very careful that you are taking your thyroid medicine at least an hour before eating in the morning so that your absorption is not impaired. High-fiber diets can change your dosage requirements, so 6 to 8 weeks after starting a high-fiber diet, you may wish to have your thyroid function tested.
THINGS TO EAT OR DRINK
THINGS TO CUT BACK OR ELIMINATE
AVOID MOST SWEETENERS WHEN POSSIBLE—EXCEPT STEVIA
There are two basic categories of sweeteners: nutritive and nonnutritive. A nutritive sweetener has 4 calories per gram and provides energy like other simple carbohydrates. Nutritive sweeteners include white and brown table sugar, molasses, honey, maple syrup, and corn syrup.
Sugar alcohols are also nutritive. These are derived from fruits or produced commercially and include sorbitol, mannitol, xylitol, and maltitol. These sweeteners are thought to perhaps be metabolized somewhat more slowly than straight glucose-based sugars, but they can still affect your blood sugar. They are also known to cause abdominal discomfort in some people.
Nonnutritive sweeteners—sugar substitutes or artificial sweeteners—are calorie-free and will not influence blood sugar. These include saccharine (e.g., Sweet ’n Low), aspartame (e.g., NutraSweet/Equal), and sucralose (e.g., Splenda). There is still ongoing controversy over the safety of the various artificial sweeteners, however, because of alleged relationships with cancer, neurological problems, and other symptoms including headaches, nausea, insomnia, dizziness, diarrhea, depression, anxiety, memory loss, and even vision changes.
Most natural health experts I know recommend that you stay away from aspartame. They are less adamant about saccharine and sucralose, and occasional use of these products is probably not going to be a problem for you.
There is one type of nutritive sweetener—stevia—that has no calories, and because it is not a carbohydrate, it does not influence blood sugar. It comes from a plant native to Paraguay. With a glycemic index of zero and no calories, stevia reduces cravings for sweets. Hundreds of studies show that stevia lowers blood pressure, helps prevent oral bacteria, and can even help regulate blood sugar. With no chemicals, it doesn’t pose some of the concerns that aspartame and the other artificial sweeteners present.
Stevia is approximately 300 times sweeter than sugar. I love it in my tea or coffee. Stevia is also versatile and can be used in hot and cold beverages, on fruit and cereals, and as a sugar replacement in baking and cooking. I like to put a drop or two of stevia into unsweetened lemon/lime seltzer and make my own sugar-free “soda.” And this actually counts toward my daily effort to get 64 or more ounces of water! I also like to use stevia to naturally sweeten plain yogurt. If you take plain low-fat or fat-free yogurt, mix in fruit and some stevia, you have healthy, low-fat fruit yogurt without the artificial sweeteners!
Just like when you first switch to any sweetener besides sugar, it takes a few days to adjust to the flavor. But once you’re used to it, it’s delicious, satisfies your sweet cravings, and regular sugar—not to mention artificial sweeteners—will taste quite “chemical” to you. My favorite brand is the Now liquid stevia for home use. And I carry the single-serving powdered packets with me to work, restaurants, and when I travel.
EAT A BIG BREAKFAST
You should aim to eat a big breakfast that contains a substantial amount of protein. In fact, aim to eat 25% of your calories at breakfast. You should also eat at least 20 grams of protein at breakfast. A protein-heavy breakfast speeds up calorie burning and gets the metabolism moving.
Some studies have shown that people eating a certain number of calories will lose weight if they eat more calories concentrated during breakfast, whereas others on the same number of calories will stay the same or even gain if they emphasize the calorie expenditure at lunch or dinner.
TRY TO EAT THREE MEALS A DAY INSTEAD OF MULTIPLE MINIMEALS
Did you know that just thinking about eating can actually trigger changes in your insulin levels and hormones that stimulate appetite? So your goal is to stop thinking about eating. (These days, I even switch off the television when they have a particularly enticing food ad so that my hormones don’t get interested!) But one of the most important ways you can stop thinking about eating is to know when you’re going to eat, and eat at regular intervals. If you eat on a fairly predictable schedule, you know when you’re not eating, so you don’t have to think about food during those times.
The controversial recommendation to eat three meals rather than grazing, or to eat five or six minimeals, as is often suggested, comes from Byron Richards, a holistic nutritionist and author of the groundbreaking book, Mastering Leptin. He says,
If 5–6 small meals a day are needed to maintain energy, the metabolic situation is not in good shape. Eating very small meals may cause some weight loss, but metabolism will likely slow down before the weight goal is achieved. Even a low calorie snack increases insulin release, thus fat-burning mode ceases or never begins. Only by increasing the amount of time between meals will proper weight loss take place.
According to Richards, this advice to eat small, frequent meals comes from the bodybuilding and diabetic communities. Bodybuilders, says Richards, can eat more times a day, because they have shortened the time that their insulin levels cycle up and down by eating consistently at high-calorie levels and burning calories intensively through their muscle development. Diabetics, according to Richards, have a malfunctioning insulin and glucagon metabolism. They have to use calories like a drug to strictly regulate insulin levels. But these examples are not necessarily applicable for the rest of us, because, according to Richards, we need to condition our liver into better responsiveness and fitness by balancing our leptin. Working toward having just three meals a day, and spacing meals 5 to 6 hours apart, is Richards’ solution to optimizing leptin balance.
I admit that it sounded counterintuitive to me, but in addition to his theories on leptin, there is justification for Richards’ recommendation. Look at the French, who do not have nearly the obesity problem that we have in the United States. Experts studying the French diet have found that the French tend to eat three meals a day, rarely snack, and take in fewer calories at a meal than most Americans. The typical slim French person is not having six minimeals throughout the day.
Research studies have also found a correlation between more meals per day and obesity. Studies found that women who were obese ate one meal more per day on average than those who were not obese. The overweight women tended to eat more between-meal snacks than the women who were of normal weight.
After switching to the three meals a day, I found that after a few days this approach actually worked for me, and I started to notice that I felt more energetic than when I was eating lots of minimeals. I also found that knowing the times when I would be eating made me stop thinking about what snack I could have, when I should have it, and so on.
In the beginning, you may still need to snack. But try cutting back to one snack a day, and eventually see if you can give up your snack entirely.
EAT A LIGHTER DINNER
AND NOTHING ELSE AFTERWARD
Dinner should be the lightest meal whenever possible. Keep in mind that most of us don’t require large portions. We especially don’t need a lot of starchy carbohydrates, like pasta, bread, potatoes, and rice. If you are going to eat starches, you’re better off eating them earlier in the day when your body needs the fuel and is more likely to burn off the calories.
Byron Richards believes that we should finish eating dinner at least 3 hours before bedtime. One of his key rules to balancing leptin is “Never eat after dinner. Allow 11–12 hours between dinner and breakfast. Never go to bed on a full stomach.”
Many experts agree with Richards that we should go to bed slightly hungry. Not so hungry or starving that hunger pangs will keep you awake, but your stomach should feel nearly empty. Your body is looking for fuel to burn during the night, and it is going to either burn undigested dinner or after-dinner snacks, or what you really want is for it to pull from your fat stores. If you go to bed with your stomach nearly empty and insulin levels are low, your body is much more likely to go to your fat stores. But if you have a big meal or a large snack before bed, you have insulin flooding your system and glucose circulating that will be stored in your fat cells.
If you’ve skipped dinner and need a snack, it should not be more than 100 calories and should ideally include a protein and a carbohydrate. Try 2 ounces of low-fat cottage cheese and a half serving of fruit, or a small serving of high-fiber breakfast cereal with a splash of milk.
Again, there is justification for Richards’ approach. In the study comparing obese women and women of normal weight, the overweight women tended to eat more food later in the day and evening than their normal-weight counterparts.
I had to get used to eating a smaller dinner and not snacking before bedtime. Before, I could easily down a dozen crackers and a piece of fruit before bed (and wake up bloated and up a half pound on the scale). But I adjusted to going to bed with an empty stomach, waking up with no bloating and with the scale showing some weight loss. It also primed me to want to eat a heartier, higher-calorie breakfast.
EAT SLOWLY, AND CHEW THOROUGHLY
Your mother always said to chew your food, and she was right! Chewing thoroughly and eating slowly is important. When you chew thoroughly, you let the digestive juices in your mouth and throat do their work to properly break down and begin digesting your food. At the same time, you extend the time you’re actually eating, giving your brain time to receive the “I feel full” feeling, which takes about 10 minutes after you start eating to generate. So slow down, and chew!
FOLLOW SOME BASIC FOOD COMBINING RULES
Why and how these rules work is a book unto itself. But there are some basic food-combining principles that you may want to try. Many people report that they have much more success with their weight-loss efforts when they follow these fairly simple rules.
STICK WITH YOUR PROGRAM ON THE WEEKENDS
One study found that most Americans consume more calories, fat, and alcohol Friday through Sunday compared with the rest of the week. Typically, those age 2 and older were eating 82 more calories per day on Friday through Sunday compared with Monday through Thursday. But the biggest increase was among those 19 to 50 years old, who were taking in 115 calories more per day. Those calories tended to come more from fat and alcohol increases, while carbohydrates and proteins dropped. If you do this every Friday, Saturday, and Sunday, those extra weekend calories could mean that every 4 months you gain more than a pound, or around 5 pounds per year! So try not to let go on the weekends!
EAT SMART WHEN YOU EAT OUT
Speaking of weekends, you may go to your favorite restaurants then. In general, Americans are eating out more than ever before. And this may be contributing to expanding waistlines.
It is so easy to wreak havoc on your weight-loss efforts if you’re not paying attention. For example, check out these calorie counts, according to the Center for Science in the Public Interest (CSPI), a Washington, D.C.–based consumer group:
So, whenever possible, choose restaurants that have healthier options. Among chain restaurants, many are recognizing the interest in healthier, lower-carbohydrate, low-fat, or low-calorie food that tastes decent. For example:
And, if you have to eat at a burger place, get a burger or chicken, take off half of the bun, get a side salad, and definitely skip the fries! One order of Burger King king-size fries (6 ounces) has 600 calories and 30 grams of fat; McDonald’s super-size fries (7 ounces) have 610 calories and 29 grams of fat. McDonald’s, Wendy’s, and other fast-food restaurants are introducing a variety of healthier entrée salads. If you don’t drown them in fatty dressings, they are better fast-food options.
KEEP TRACK OF WHAT YOU EAT
Until eating healthy foods, avoiding foods and activities that cause you to gain weight, and exercising regularly all become habit, you can use some help. This is where tools for planning and tracking, as well as support from other people on the journey, can make or break the success of your efforts. There are many dozens of tools and options out there for you—from individual weight-loss counselors and experts in your own area to nationally known programs, from simple tracking sheets to sophisticated programs you can run on your personal data assistant (PDA).
I’ve reviewed or tried many programs but am recommending only a few that are readily available, because they are user-friendly, provide support and tools to aid you in your weight-loss effort, and are accessible to most people around the country.
One of the most powerful things you can do is write things down. Studies have shown that people who write down everything they eat can actually lose weight, even if not formally dieting, simply because the act of writing it down makes them more aware and likelier to make better choices. Write down your goals. Plan what you’re going to eat. Keep track of calories, carbs, fat, water, or other nutrients, and exercise hours, intensity, or calories burned.
There are special books and journals you can buy for this purpose. One particularly good diary is the Fat Tracker Daily Diary, from Karen Chisholm. See www.thefattracker.com for more information. You can also use your PDA, a notepad, your computer, a calendar, or a looseleaf binder. It doesn’t matter what form your journal takes; it’s the action of sitting down and thinking about your goals, what you’re going to eat, and assessing what you’ve eaten that makes the difference.
To get you started, I included simple tracking sheets in Chapter 9 that you can photocopy and use to keep track of your food, exercise, and supplement intake. Other sites and tools are also in this section and are featured at www.goodmetabolism.com. If you want a more formalized way to keep close track of your nutritional intake, emotions, and fitness, there are some tools I highly recommend.
DietPower
DietPower is a software program that nutritionally analyzes the foods you’ve eaten, calculates your calorie intake along with dozens of different nutrients, and keeps track of the calories burned in various exercises and fitness activities. The program even keeps track of proper water intake and is entirely customizable in terms of your target ratios of fats, carbs, and proteins, for example. One of the most unique aspects of DietPower is its ability to “learn” your metabolism. It monitors your metabolism and adjusts daily calorie targets in recognition of your unique metabolic rate while tracking your intake of 33 nutrients, calories burned in exercise, and water intake. It is not a diet or a program that tells you what to eat; it is a tool that shows you what you’ve eaten and evaluates your metabolism. A free downloadable trial version lets you test this tool to see if it’s a good fit for you.
Ediets and Weight Watchers Online
Both of these diet powerhouse sites have capabilities to keep track of what you eat, how much, and your exercise and fitness. Ediets, with multiple diet approaches to choose from—for example, Atkins, low-fat, diabetic—has more options in terms of the overall food approach. Weight Watchers, with its point program, is somewhat less flexible, because it doesn’t differentiate between carbs and protein, for example, in assigning points. Overall calories, fat, and fiber are mainly used to calculate the point value of a food. But the points program is a very easy way to keep track of things, and if you use their program but choose low-glycemic foods over higher-glycemic carbohydrates, the points approach can be a useful tracking device. Weight Watchers also has a very easy-to-learn interface. I tried the site and within about 15 minutes had my targets and point calculations for the day already entered, and I was navigating with ease. Ediets, with more options and permutations, is not quite as simple to navigate but is rich with content and information.
Physique Transformation Program’s Personal Food Analyst
One unique tracking tool available only online is the Physique Transformation Program’s Personal Food Analyst, or PFA. The PFA has a vast database of many thousands of foods—everything from fast foods to restaurant specialties to supermarket brands are here. According to your own or the program’s goals for various nutrients and food components such as protein, fat, and carbs, the program gives you a letter grade—A+, A, B+, B, and so on, down to F—based on how you did for the day compared to your goals. This approach is particularly appealing, inspires the competitive aspect in many people, and is easy to understand.
PLAN WHAT YOU’RE GOING TO EAT AND BUY
When it comes to planning, Physique Transformation’s Personal Food Analyst will let you enter foods and exercise in advance so that you can essentially plan out ahead of time what you will eat and what exercise you will do. If you select the right foods, shooting for an A rating from the program, then follow your own plan, you can guarantee that you’ll eat well. The Personal Food Analyst doesn’t tell you what to eat, however, so you will need to come up with your own ideas and make your own choices.
Ediets and Weight Watchers online really shine for those who want it all planned out—even to the extent of generating an automatic grocery shopping list. You can pick out menus you like—many options in both programs include frozen low-calorie meals and other convenience foods or fully cooked gourmet meals—for an entire week, and get the menus and recipes printed out, along with shopping lists. If you don’t want to think about it and don’t want to plan anything, these approaches may be right for you.
Weight Watchers also has a really useful feature called Recipe Builder, which lets you enter a recipe and get a Weight Watchers point count for it. You can then modify ingredients and preparation techniques to make the recipe healthier and reduce the point count.
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 500 people, half of whom were doing a self-help weight-loss program and half who were doing a commercial weight-loss program. After 2 years, about 150 people from each group were still continuing. The self-help group lost about 3 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 10 pounds in the first year and after the second year concluded they were still an average of 6 pounds lighter than when they started. Those who went to even 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. Local hospitals 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 compatible style and philosophy to 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 are not typically experts in physiology, nutrition, weight loss, or cognitive behavior, although they are trained to help you implement their company’s program.
Finally, more and more people are turning to online support communities, ranging from the more formalized weight-loss communities at places like Ediets, Weight Watchers Online, and Physique Transformation, to AOL’s numerous weight-loss and diet chat rooms—informal places like my own Thyroid Diet & Weight Loss Support Forum. There are thousands of interactive forums, bulletin boards, chats, list servs, and other interactive online support activities available 24 hours a day. The key is to find the community that has the types of support you need when you need it. If you’re looking for a range of support, one of the bigger sites, like Ediets or Weight Watchers Online, might be a good choice, because you’ll find support communities focused on different approaches, different amounts of weight to be lost, fitness issues, and numerous expert chats where you can ask questions from counselors and experts. Basically, you’ll find a great deal of variety in terms of support offered. If you are a diabetic following a gluten-free diet trying to lose weight, you’ll want to find a specialized support group of others in the same situation.