Thyroid for Dummies (31 page)

Chapter 15

Living with Thyroid Problems:

Diet and Exercise

In This Chapter

ᮣ Working to assure your best nutrition

ᮣ Evaluating your thyroid and weight loss

ᮣ Remembering the importance of iodine

ᮣ Using exercise to maintain thyroid and body health

ᮣ Understanding leptin and your thyroid

Your thyroid gland functions at its best if it finds itself in a healthy body whose tissues receive the right nutrients and whose muscles and bones are strengthened by an appropriate level of exercise. In this chapter we give you a guide on how to easily determine your ideal weight for your height, and discusses some basic ideas about diet and exercise.

Guaranteeing Your Best Nutrition

Two friends run into each other, and the first friend asks how the second one feels. The second friend answers, ‘Lousy, I’ve got arthritis, a bad back, I’m always tense, I have insomnia. Miserable, I’m miserable.’ ‘And what kind of work are you doing?’ the first friend asks. ‘The same thing – I’m still selling health foods.’

This story is good for a chuckle, but the truth is that your diet and lifestyle habits, such as drinking and smoking, have more influence on your health than all the diseases in a textbook of medicine.

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A number of organisations have published healthy eating guidelines to help you follow the optimum, healthy diet. These messages include suggestions such as:

ߜ Enjoy your food

ߜ Eat as wide a variety of foods as possible

ߜ Eat the right amount to maintain a healthy weight

ߜ Eat more fruit and vegetables to ensure you get sufficient vitamins and minerals in your diet – five or more servings of fruit and vegetables per day is ideal

ߜ Eat plenty of wholegrain foods rich in fibre

ߜ Consider the overall balance of fats in your diet and don’t eat too much of any

ߜ Eat at least two portions of fish, including one of oily fish per week ߜ Switch to reduced-fat spreads and dairy products from full-fat ones ߜ Eat more monounsaturated fats (for example, olive oil) ߜ Use salt and sugar in moderation

ߜ Consume alcoholic beverages, if you do so, in moderation Foods aren’t really good or bad for you – getting a healthy balance is what counts. Keep fatty, sugary foods as occasional treats because banning foods altogether can make you fancy them even more.

Maintaining a Healthy Weight

If you go online and check out a message board about thyroid disease, you’ll probably find that lots of people have lots of questions about how the thyroid affects weight gain and loss. This section helps set the record straight.

Maintaining a healthy weight is important to help reduce your risk of a number of health problems including:

ߜ Diabetes

ߜ High blood pressure

ߜ Abnormal blood cholesterol levels

ߜ Hardening and furring up of the arteries

ߜ Coronary heart disease and stroke

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Calculating your body mass index

Your body fat stores are usually estimated using the Body Mass Index (BMI).

This figure is calculated by dividing your weight in kilograms by your height in metres squared:

BMI = Weight (Kg) ÷ Height (m) ÷ Height (m)

This calculation gives you a figure that is interpreted as follows:

< 20

Underweight

20–25

Healthy weight

25–30

Overweight

30–40

Obese

> 40

Severe obesity

For example, if your height is 5 feet 7 inches (1.7 metres), and your weight is 12 stone (76 kilograms) your BMI is calculated as 76 divided by 1.7, then divided by 1.7 again = 26.29, which means you’re slightly overweight.

As this calculation is too complicated for someone with a life to perform, Table 15-1 makes it easy for you. This table shows the healthy weight range for your height (for adults), based on a BMI of 20 – 25 kg/M2. If, for example, someone is 5 feet 7 inches (1.7 metres) and they weigh 12 stone (76 kilograms), they are above their ideal weight range of between 9 stone 1 pound and 11

stone 4 pounds (58–72 kilograms). If your weight falls above the range given for your height, try to lose weight slowly and steadily until you reach the healthy range for your height.

You need to be aware that this calculation is meant as a broad guide only, and should not replace a visit to your doctor for advice on how to safely lose weight. The BMI doesn’t take into account your gender or body type, for example, if you’re a very muscular male this fact isn’t reflected in the calculation as muscle weighs heavier than fat.

Table 15-1

Body Mass Index Healthy Weight Range

in Relation to Height

Height (Metres/Feet)

Weight

(Kilograms/Stones)

1.47 4’10”

43–54

6st 11–8st 7lb

1.50 4’11”

45–56

7st 1–8st 11lb

(continued)

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Table 15-1 (continued)

Height (Metres/Feet)

Weight

(Kilograms/Stones)

1.52 5ft

46–58

7st 3–9st 2lb

1.55 5’1”

48–60

7st 8–9st 7lb

1.57 5’2”

49–62

7st 10–9st 11lb

1.60 5’3”

51–64

8st–10st 1lb

1.63 5’4”

53–66

8st 5–10st 6lb

1.65 5’5”

54–68

8st 7–10st 10lb

1.68 5’6”

56–70

8st 12–11st

1.70 5’7”

58–72

9st 1–11st 4

1.73 5’8”

60–75

9st 6–11st 10

1.75 5’9”

61–76

9st 9–12st

1.78 5’10”

63–79

9st 13–12st 6

1.80 5’11”

65–81

10st 3–12st 9

1.83 6 ft

67–83

10st 7–13st 1

1.85 6’1”

69–85

10st 11–13st 5

1.88 6’2”

71–88

11st 2–13st 12

1.90 6’3”

72–90

11st 5–14st 2

1.93 6’4”

75–93

11st 10–14st 8

Measuring your waist size

When you are overweight, the place where you store your excess weight is important. If you store excess fat round your middle (apple-shaped), you’re twice as likely to develop coronary heart disease as someone storing excess fat around their hips (pear-shaped). To work out if you are apple-shaped, measure your waist and hip in centimetres using a non-stretchable tape measure. Divide your waist measurement by your hip measurement to get your waist to hip ratio.

For example, if your waist is 88 centimetres, and your hips are 100 centimetres, then your waist to hip ratio is 88/100 = 0.88.

A waist/hip ratio greater than 0.85 is apple-shaped for women, while a ratio greater than 0.95 is apple-shaped for men.

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In fact, waist size alone is a good indicator of health. Research suggests that men with a waist circumference larger than 102 centimetres and women with a waist circumference larger than 88 centimetres are more likely to have shortness of breath, high blood pressure, high cholesterol levels, and diabetes than those with slimmer waistlines. Slight waist reductions of just 5–10 centimetres can significantly reduce your risk of a heart attack.

Losing excess weight

The best way to lose weight permanently is to change your eating habits, so you eat more healthily without feeling as if you’re actually on a diet. Look on losing weight as a healthy eating plan for the rest of your life, rather than a temporary slimming phase.

Importantly, to lose weight you also need to increase your level of physical activity. Exercise burns off excess calories and boosts your metabolic rate as well as improving the fitness of your heart and lungs. Try to exercise for at least 30 minutes on five days per week. Once you are fit, aim to do more. Start off slowly if you are unfit, and build up to exercise briskly enough to work up a light sweat and make yourself slightly breathless. Try these effective forms of exercise:

ߜ Brisk walking

ߜ Cycling

ߜ Swimming

ߜ Dancing

ߜ Vigorous housework

ߜ Gardening

Don’t set yourself unrealistic targets. At first, just aim to stop your weight increasing and prevent the downhill spiral. Then look at how you can slowly lose the pounds – just one or two pounds per week soon adds up to a significant weight loss over the coming months.

Selecting a variety of foods

You’ve probably heard the phrase ‘eat a balanced diet’ many times, but what exactly does that mean? Eating a balanced diet just means eating enough of the right sorts of foods, in the right amounts, to provide all the energy, carbohydrate, protein, fat, vitamins, and minerals you need on a daily basis. A healthy, balanced diet gives you:

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ߜ Enough energy to fuel your level of physical activity and maintain a healthy weight

ߜ Enough protein for tissue repair, regeneration, and rejuvenation ߜ Enough essential fatty acids (omega-3) that your body is unable to produce itself

ߜ At least the recommended daily amount of vitamins and minerals ߜ Enough fluid to maintain a normal water balance

Different people need different amounts of foods depending on their level of physical activity – both at work and leisure – their height, weight, age, and the metabolism they have inherited. In general, however, most people benefit from eating:

ߜ More starchy (complex or unrefined) carbohydrates, such as wholegrain cereals

ߜ More fresh fruit and vegetables

ߜ More unsalted nuts and seeds

ߜ More fish, especially oily fish

ߜ Less fat, especially saturated fat

ߜ Less processed, ready-made products

Most people obtain more than enough protein from their diet, and cutting back on fatty foods and those that are protein-rich helps to make room for more fruit and vegetables.

The food proportions that help to make up a balanced diet are illustrated on a plate diagram.

As you can see in Figure 15-1, all types of foods are included – even chocolate and biscuits. There are no such things as ‘good’ or ‘bad’ foods in a healthy, balanced diet as long as you go easy on sugary, fatty foods and do not eat them in excess. The five main food groups included in the plate diagram are: ߜ
Fruit and vegetables:
Fresh, frozen, and canned; pure juices and dried fruits. Try to eat at least five portions of fruit and veg a day. As a rough guide, a portion is:

• 1 small glass of fruit juice

• 2 tablespoons of vegetables

• 1 piece of fresh fruit

• Small handful of fruits, such as grapes or strawberries

• Small bowl of salad

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Fresh fruit

Represents

and vegetables

carbohydrate

foods

Figure 15-1:

Food types,

and the part

Beans, pulses,

they play in

Dairy products;

high-protein

a balanced

cheese, milk,

food

diet.

Sugary foods,

yoghurt

saturated fats

ߜ
Lean meat, poultry, fish, and vegetarian alternatives:
Altogether, you need to eat two or three servings of these protein-rich foods per day, where one serving counts as:

• 60–90 grams (2–3 ounces) of meat, poultry, or oily fish

• Small can of beans

• 240 grams (8 ounces) of cooked pulses

• 120 grams (4 ounces) of fish

• 1 egg (not fried)

Try to have fish twice a week, including one portion of oily fish (for example, salmon, herring, mackerel, sardines, and pilchards). Alternative sources of protein are pulses, nuts, seeds, and soya products.

ߜ
Milk and dairy foods:
Try to select low-fat versions such as semi-skimmed or skimmed milk, and lower fat cheeses such as Gouda, Edam, or cottage cheese. Aim to eat 2–3 measures of these a day, where a measure is:

• 200 millilitres (one-third of a pint) of semi-skimmed/skimmed milk

• 30 grams (1 ounce) of cheese

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• 1 small pot of yoghurt

• 120 grams (4 ounces) of cottage cheese

ߜ
Bread, cereals, and potatoes:
This group includes savoury crackers, noodles, oats, chapattis, pasta, and rice. You can eat 5–14 measures of these foods per day, depending on your energy needs (manual workers need more than office workers, for example). A measure is:

• 1 slice of bread

• 5 tablespoons of breakfast cereal

• 2 tablespoons of cooked rice, pasta, or noodles

• 2 egg-sized potatoes

ߜ
Fatty and sugary foods:
Includes margarine and butter, cooking oils and sugar. In a healthy balanced diet, these foods are used in moderation only, so watch your intake of fried foods, crisps, biscuits, and high-fat, high-sugar snacks. Most people eat far too many of these foods, so cut right back on them and use low-fat, low-sugar products where possible.

Taking vital vitamins

Although vitamins are only needed in tiny amounts, they are essential for health. Vitamins are involved in energy-producing chemical reactions in your body and must come from your diet as your body cannot make them. The various vitamins, their function, and their sources in food include the following: ߜ
Vitamin A:
Used for vision and growth of bone and teeth, is found in liver, carrots, and spinach.